芪苈强心胶囊联合尼可地尔对射血分数保留性心力衰竭患者心功能及细胞因子的影响  

Effect of Qiliqiangxin capsules combined with nicorandil on cardiac function and cytokines in patients with heart failure with preserved ejection fraction

作　　者：马建飞 刘宪桂 赵靖华 张红斌[1] 张巍[1] 刘飞 马婷 MA Jian-fei;LIU Xian-gui;ZHAO Jing-hua;ZHANG Hong-bin;ZHANG Wei;LIU Fei;MA Ting(Department of Cardiology,Cangzhou Central Hospital,Cangzhou 061000,Hebei,China)

机构地区：[1]沧州市中心医院心血管内三科,河北沧州061000 [2]河北省沧州中西医结合医院血液内科,河北沧州061000 [3]沧州市中心医院超声三科,河北沧州061000

出　　处：《广东医学》2023年第3期379-382,共4页Guangdong Medical Journal

基　　金：沧州市重点研发计划指导项目(213106031)。

摘　　要：目的探讨芪苈强心胶囊联合尼可地尔对射血分数保留性心力衰竭患者心功能及细胞因子的影响。方法连续入选2019年10月至2020年10月诊断为射血分数保留性心力衰竭的患者共90例,随机分为观察组(45例)与对照组(45例)。对照组给予常规抗心力衰竭药物加芪苈强心胶囊治疗,观察组在对照组治疗基础上,加用尼可地尔治疗。比较两组患者一般临床资料、细胞因子水平、心功能各项指标。随访1年患者心功能情况、细胞因子水平以及不良心脑血管事件(MACCEs)发生情况。结果两组患者接受治疗1年后脑钠肽(BNP)、左室舒张末期内径、白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)均降低,射血分数(EF)值较治疗前升高,差异有统计学意义(P<0.05)。组间对比发现,两组患者入院时基础BNP、细胞因子、超声心能指标(LVEF、左室舒张末期内径、左房内径)差异无统计学意义(P>0.05);接受治疗1年后观察组IL-1β、IL-6、TNF-α、BNP、左室舒张末期内径低于对照组,EF值高于对照组,差异有统计学意义(P<0.05)。随访1年对照组共有7例发生终点事件,观察组共有4例发生终点事件,Kaplan-Meier生存分析显示,观察组与对照组累计无事件生存率为91.1%vs.84.4%,差异无统计学意义(Log-rank 1.038,P=0.308)。结论芪苈强心胶囊联合尼可地尔可降低炎性细胞因子,减轻心肌炎性损伤,改善射血分数保留性心力衰竭患者心脏功能。Objective To investigate the effect of Qiliqiangxin capsules combined with nicorandil on cardiac function and cytokines in patients with heart failure with preserved ejection fraction.Methods A total of 90 patients with heart failure with preserved ejection fraction were consecutively selected in our department from October 2019 to October 2020,and were randomly divided into observation group(45 cases)and control group(45 cases).The control group was treated with conventional anti-heart failure drugs plus Qiliqiangxin capsules,and the observation group was treated with nicorandil on the basis of the treatment in the control group.The general clinical data,cytokine levels and cardiac function indexes of the two groups were compared.Cardiac function,cytokine levels and occurrence of MACCEs were followed up for 1 year.Results One year after treatment,BNP,left ventricular end-diastolic diameter,IL-1β,IL-6,and TNF-αin the two groups were significantly reduced,and the EF value was significantly increased compared with those before treatment(P<0.05).The comparison between the two groups showed that there was no significant difference in the basic BNP,cytokines,or echocardiographic indexes(LVEF,left ventricular end-diastolic diameter,left atrial diameter)between the two groups at admission(P>0.05).After one year follow-up,the IL-1β,IL-6,TNF-α,BNP,and left ventricular end-diastolic diameter in the observation group were significantly lower than those in the control group,and the EF value was significantly higher than that in the control group(P<0.05).There were 7 cases of end-point events in the control group and 4 cases of end-point events in the observation group.The Kaplan-Meier survival analysis showed that the cumulative event-free survival rate between the observation group and the control group was 91.1%vs.84.4%,with no significant difference(P=0.308).Conclusion Qiliqiangxin capsules combined with nicorandil can reduce inflammatory cytokines,relieve myocardial inflammatory injury,and improve cardiac function in

关 键 词：射血分数保留 芪苈强心胶囊 尼可地尔 细胞因子 

分 类 号：R541.6[医药卫生—心血管疾病] R540.4[医药卫生—内科学]