常规急救方案联合灯盏生脉饮治疗急性心力衰竭合并糖尿病患者的疗效及对血气指标、心功能和糖脂代谢的影响  

Efficacy of routine emergency treatment combined with Dengzhan Shengmai Decoction in the treatment of patients with acute heart failure complicated with diabetes and its effects on blood gas index,cardiac function,glucose and lipid metabolism

作　　者：王小华[1] 马文辉[1] 郭爽 WANG Xiao-hua;MA Wen-hui;GUO Shuang(Department of Emergency,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院急诊科,北京100176

出　　处：《临床和实验医学杂志》2024年第11期1145-1149,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市通州区科技计划项目(编号:KJ2014CX007-12)。

摘　　要：目的探讨常规急救方案联合灯盏生脉饮治疗急性心力衰竭(AHF)合并糖尿病患者的疗效及对血气指标、心功能和糖脂代谢的影响。方法回顾性选取2021年9月至2022年12月首都医科大学附属北京同仁医院收治的AHF合并糖尿病患者80例作为研究对象,按治疗方法不同将患者分为观察组与对照组,每组各40例。对照组患者采取常规急救方案,如无创呼吸机、硝普钠、多巴胺治疗等,观察组患者在对照组基础上给予灯盏生脉饮治疗,两组均治疗20 d。比较两组患者急救效果,并比较两组患者的治疗前、治疗后1 d的血气指标[动脉二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))]、氨基末端脑钠素前体(NT-proBNP)水平、心功能[左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、每搏心输出量(SV)]、糖脂代谢[糖化血红蛋白(GHb)、空腹血糖(FPG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平及不良反应。结果观察组患者急救总有效率为92.50%,显著高于对照组(77.50%),差异有统计学意义(P<0.05)。观察组患者治疗后1 d的PaO_(2)为(75.23±7.98)mmHg,显著高于对照组[(61.23±7.31)mmHg],PaCO_(2)、NT-proBNP水平分别为(37.38±6.89)mmHg、(529.63±189.74)pg/mL,均显著低于对照组[(46.13±7.07)mmHg、(695.45±263.32)pg/mL],差异均有统计学意义(P<0.05)。观察组患者治疗后1 d的LVESV、LVEDV、SV分别为(109.71±9.65)、(173.48±18.72)、(79.77±9.32)mL,均低于对照组[(130.45±13.53)、(210.75±21.34)、(89.34±9.02)mL],LVEF为(54.38±6.04)%,显著高于对照组[(45.23±5.49)%],差异均有统计学意义(P<0.05)。观察组FPG、GHb、LDL-C水平分别为(6.04±1.01)mmol/L、(6.03±0.94)%、(1.82±0.59)mmol/L,均显著低于对照组[(7.69±1.01)mmol/L、(7.68±0.51)%、(2.82±0.62)mmol/L],HDL-C水平为(3.24±0.21)mmol/L,显著高于对照组[(2.28±0.20)mmol/L],差异均有统计学意义(P<0.05)。对照组与�Objective To explore the efficacy of routine emergency treatment combined with Dengzhan Shengmai Decoction in the treatment of patients with acute heart failure(AHF)complicated with diabetes and its effects on blood gas index,cardiac function,glucose and lipid metabolism.Methods A total of 80 patients with AHF complicated with diabetes admitted to Beijing Tongren Hospital,Capital Medical University from September 2021 to December 2022 were retrospectively selected as the research objects.According to different treatment methods,the patients were divided into observation group and control group,with 40 cases in each group.The patients in the control group were treated with conventional emergency treatment,such as non-invasive ventilator,sodium nitroprusside,dopamine treatment,etc.The patients in the observation group were treated with Dengzhan Shengmai Decoction on the basis of the control group.Both groups were treated for 20 days.The first aid effects of the two groups were compared.The blood gas indexes[arterial carbon dioxide partial pressure(PaCO_(2)),arterial oxygen partial pressure(PaO_(2))],N-terminal pro-brain natriuretic peptide(NT-proBNP)level,cardiac function[left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),stroke volume(SV)],glucose and lipid metabolism[glycosylated hemoglobin(GHb),fasting blood glucose(FPG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]levels before treatment and 1 d after treatment and adverse reactions were compared between the two groups.Results The total effective rate of emergency treatment in the observation group was 92.50%,which was significantly higher than that in the control group(77.50%),the difference was statistically significant(P<0.05).After 1 day of treatment,the PaO_(2) of the observation group was(75.23±7.98)mmHg,which was significantly higher than that of the control group[(61.23±7.31)mmHg],the levels of PaCO_(2) and NT-proBNP in the observat

关 键 词：心力衰竭 糖尿病 灯盏生脉饮 无创呼吸机 硝普钠 多巴胺 

分 类 号：R587.2[医药卫生—内分泌] R541.6[医药卫生—内科学]