麝香保心丸介导的内皮功能改变对心梗后心衰患者短期预后影响的临床研究  

Clinical study on the effect of Shexiang Baoxin Pill mediated changes of endothelial function on short-term prognosis of patients with heart failure after myocardial infarction

作　　者：廖然[1] 韩青 张历 LIAO Ran;HAN Qing;ZHANG Li(Department of Cardiovascular Medicine,Jiujiang No.1 People's Hospital,Jiujiang 332000,China)

机构地区：[1]九江市第一人民医院心血管内科,332000

出　　处：《中国现代药物应用》2024年第11期1-4,共4页Chinese Journal of Modern Drug Application

基　　金：江西省中医药管理局科技计划(项目编号:SZYYB20230421)项目名称:麝香保心丸介导的内皮功能改变对心梗后心衰患者短期预后影响的临床研究。

摘　　要：目的分析麝香保心丸介导的内皮功能改变对心肌梗死(心梗)后心力衰竭(心衰)患者短期预后的影响。方法纳入心梗后心衰患者43例为研究对象,以随机分组方式分为对照组(21例)与观察组(22例)。两组患者均接受常规冠心病及心衰二级预防西药用药,观察组患者在常规西药治疗基础上联合麝香保心丸口服用药治疗。比较两组心功能[心率(HR)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]、血常规指标[凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、血小板聚集试验(PAgT)]、流式细胞学指标[辅助性T淋巴细胞1(Th1)、辅助性T淋巴细胞17(Th17)及调节性T细胞(Treg)]、炎性因子[白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平。结果观察组患者治疗1年后LVEF(59.12±3.83)%高于对照组的(55.88±3.97)%,HR(76.14±6.69)次/min、LVEDD(54.47±2.91)mm低于对照组的(80.61±5.92)次/min、(57.63±2.16)mm,统计学意义成立(P<0.05)。治疗1年后,观察组PT(13.93±2.01)s长于对照组的(12.63±2.07)s,FIB(4.02±0.98)g/L、PAgT(59.63±7.31)%均低于对照组的(4.79±1.02)g/L、(67.56±6.91)%,统计学意义成立(P<0.05)。观察组治疗1年后Th1、Th17低于对照组,Treg高于对照组,统计学意义成立(P<0.05)。治疗1年后,观察组患者IL-10(36.67±6.38)pg/ml、IL-6(130.63±24.36)pg/ml、CRP(33.12±8.93)mg/L均低于对照组的(43.08±7.11)pg/ml、(169.67±29.61)pg/ml、(49.68±10.47)mg/L,统计学意义成立(P<0.05)。结论麝香保心丸介导的内皮功能改变能显著提升心梗后心衰患者的心功能水平,增强机体免疫功能,降低机体炎症因子水平,麝香保心丸综合应用价值较高,建议临床推广使用。Objective To analyze the effect of Shexiang Baoxin Pill mediated changes of endothelial function on short-term prognosis of patients with heart failure after myocardial infarction.Methods 43 patients with heart failure after myocardial infarction were included in the study,and were randomly divided into a control group(21 cases)and an observation group(22 cases).Patients in both groups received conventional Western drugs for secondary prevention of coronary heart disease and heart failure,and patients in the observation group were treated with Shexiang Baoxin pill on the basis of conventional Western medicine treatment.Both groups were compared in terms of cardiac function[heart rate(HR),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],routine blood parameters[prothrombin time(PT),plasma fibrinogen(FIB),platelet aggregation test(PAgT)],flow cytometry indicators[helper T lymphocyte 1(Th1),helper T lymphocyte 17(Th17)and regulatory T cells(Treg)],inflammatory factors[interleukin-10(IL-10),interleukin-6(IL-6),C-reactive protein(CRP)].Results After 1 year of treatment,the observation group had higher LVEF of(59.12±3.83)%than(55.88±3.97)%in the control group;the observation group had HR of(76.14±6.69)beats/min and LVEDD of(54.47±2.91)mm,which were lower than(80.61±5.92)beats/min and(57.63±2.16)mm in the control group;the statistical significance was established(P<0.05).After 1 year of treatment,the observation group had longer PT of(13.93±2.01)s than(12.63±2.07)s in the control group;the observation group had FIB of(4.02±0.98)g/L and PAgT of(59.63±7.31)%,which were lower than(4.79±1.02)g/L and(67.56±6.91)%in the control group;the statistical significance was established(P<0.05).After 1 year of treatment,Th1 and Th17 in the observation group were lower than those in the control group,and Treg was higher than that in the control group.The statistical significance was established(P<0.05).After 1 year of treatment,the observation group had IL-10 of(36.67±6.38)pg/ml,IL-6

关 键 词：麝香保心丸 内皮功能 心肌梗死后心力衰竭 短期预后 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]