芪苈强心胶囊联合静脉补铁治疗慢性心力衰竭合并缺铁患者的临床疗效  

Clinical Effect of Qiliqiangxin Capsule Combined with Intravenous Iron Supplement on Patients with Chronic Heart Failure and Iron Deficiency

作　　者：孙小燕 吴泽阳 王蕾 屈伶玉 杨雷 SUN Xiaoyan;WU Zeyang;WANG Lei;QU Lingyu;YANG Lei(Department Three of Cardiology,Zhangjiakou First Hospital,Zhangjiakou 075000,China;Department of Rehabilitation,Zhangjiakou First Hospital,Zhangjiakou 075000,China;Department of Hematology,Zhangjiakou First Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院心内三科,河北张家口075000 [2]张家口市第一医院康复科,河北张家口075000 [3]张家口市第一医院血液科,河北张家口075000

出　　处：《医学综述》2023年第4期821-826,共6页Medical Recapitulate

基　　金：张家口市重点研发计划项目(2121151D)。

摘　　要：目的研究芪苈强心胶囊联合静脉补铁治疗慢性心力衰竭合并缺铁患者的临床疗效。方法收集2020年9月至2021年9月张家口市第一医院收治的106例慢性心力衰竭合并缺铁患者的临床资料,根据治疗方式不同分为对照组(51例)和研究组(55例)。两组均给予常规抗心力衰竭治疗,对照组在常规治疗基础上联合静脉补铁治疗,5 ml蔗糖铁溶于100 ml 0.9%氯化钠溶液中静脉滴注;研究组在对照组的基础上口服芪苈强心胶囊,每次4粒,每日3次。两组均连续治疗3个月。比较两组的临床疗效,治疗前后血清铁指标[铁蛋白(SF)、血红蛋白(Hb)、总铁结合力(TIBC)、转铁蛋白饱和度(TS)]、6 min步行试验(6MWT)距离、左心室射血分数(LVEF)、美国纽约心脏病协会(NYHA)心功能分级、血清脑钠肽(BNP)、左心室舒张末期内径(LVEDd)水平以及不良反应发生情况。结果研究组临床总有效率高于对照组[89.09%(49/55)比68.63%(35/51)](χ^(2)=6.737,P=0.009)。治疗前后血清SF、Hb、TIBC、TS水平的主效应、组间的主效应差异有统计学意义(P<0.01),各指标组间和时点间存在交互作用(P<0.01);治疗后,两组血清SF、Hb、TIBC、TS水平均高于治疗前(P<0.05),且研究组高于对照组(P<0.05)。治疗前后6MWT距离、LVEF水平的主效应、组间的主效应差异有统计学意义(P<0.01),各指标组间和时点间存在交互作用(P<0.01);治疗后,两组6MWT距离、LVEF水平均高于治疗前(P<0.05),且研究组高于对照组(P<0.05)。治疗后,两组NYHA心功能分级均优于治疗前(P<0.01),且研究组优于对照组(P<0.01)。治疗前后BNP、LVEDd水平的主效应、组间的主效应差异有统计学意义(P<0.01),各指标组间和时点间存在交互作用(P<0.01);治疗后,两组血清BNP、LVEDd水平均低于治疗前(P<0.05),且研究组低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论芪苈强心胶囊联合静脉补铁治疗慢性心Objective To study the clinical effect of Qiliqiangxin capsule combined with intravenous iron supplement on patients with chronic heart failure and iron deficiency.Methods The clinical data of 106 patients with chronic heart failure combined with iron deficiency admitted to Zhangjiakou First Hospital from Sep.2020 to Sep.2021 were collected and divided into a control group(51 cases)and a study group(55 cases)according to different treatment methods.Both groups were given conventional anti-heart failure treatment,and the control group was combined with intravenous iron supplementation(5 ml of iron sucrose dissolved in 100 ml 0.9%sodium chloride solution by intravenous drip),whilethe study group was added with Qiliqiangxin capsule(4 capsules each time,3 times a day,oral)on the basis of the control group′s regimen.Both groups were treated continuously for 3 months.The clinical effects of the two groups were compared,including serum iron indicators[ferritin(SF),hemoglobin(Hb),total iron binding capacity(TIBC),transferrin saturation(TS)],6-minute walk test(6MWT)distance,left ventricular ejection fraction(LVEF),NYHA cardiac function classification,serum brain natriuretic peptide(BNP),left ventricular end diastolic diameter(LVEDd)level before and after treatment,as well as adverse reactions.Results The total effective rate of the study group was higher than that of the control group[89.09%(49/55)vs 68.63%(35/51)](χ^(2)=6.737,P=0.009).The main effects of serum SF,Hb,TIBC and TS levels before and after treatment and between groups were statistically significantly different(P<0.01),and there were interactions between groups and time points(P<0.01).After treatment,serum SF,Hb,TIBC and TS levels in both groups were higher than before treatment(P<0.05),and the study group higher than the control group(P<0.05).The main effect of 6MWT distance and LVEF levels before and after treatment and between groups were statistically significantly different(P<0.01),and there were interactions between groups and time points(P<0.01).Afte

关 键 词：慢性心力衰竭 缺铁 静脉补铁 芪苈强心胶囊 

分 类 号：R541[医药卫生—心血管疾病]