心衰保元汤治疗PCI术后射血分数保留型心力衰竭疗效及对患者血清Gal-3、sST2的影响  

Efficacy of Xinshuai Baoyuan decoction in the treatment of heart failure with preserved ejection fraction after PCI and its effect on serum Gal-3 and sST2

作　　者：张悦 艾克荣 ZHANG Yue;AI Kerong(Cardiovascular Hospital,Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710021,China)

机构地区：[1]西安市中医医院心血管病院,陕西西安710021

出　　处：《陕西中医》2025年第1期51-55,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(202224JC-YBMS-753)。

摘　　要：目的:探讨心衰保元汤治疗经皮冠状动脉介入术(PCI)后射血分数保留型心力衰竭(HFpEF)的疗效及对患者血清半乳糖凝集素3(Gal-3)、可溶性致癌抑制因子2(sST2)的影响。方法:将PCI后发生HFpEF的患者86例随机分为两组,对照组(n=43)接受常规西医治疗,观察组(n=43)在对照组基础上加用心衰保元汤治疗,疗程为12周。记录两组临床疗效,比较两组治疗前后相关心功能指标、超声心动图指标、血清Gal-3、sST2水平。比较两组治疗后随访6个月时的心血管不良事件发生率。结果:观察组临床总有效率显著高于对照组(P<0.05)。与治疗前比较,治疗后两组Lee氏心衰积评分、心功能NYHA分级、血清N末端脑钠肽原(NT-proBNP)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室质量指数(LVMI)均显著降低(P<0.05),且观察组降低程度高于对照组(P<0.05);观察组6 min步行试验距离、左室射血分数(LVEF)、舒张早期/晚期二尖瓣血流峰值(E/A)均增加(P<0.05),且观察组增加程度高于对照组(P<0.05)。与治疗前比较,治疗后两组血清Gal-3、sST2水平均显著降低(P<0.05),且观察组降低程度高于对照组(P<0.05)。观察组随访6个月时心血管不良事件发生率显著低于对照组(P<0.05)。结论:在西医治疗基础上加用心衰保元汤可有效提高PCI后HFpEF的临床疗效,抑制心室重构,改善心脏功能,下调血清Gal-3、sST2表达水平,从而有利于降低心血管不良事件发生率。Objective:To investigate the efficacy of Xinshuai Baoyuan decoction in the treatment of heart failure with preserved ejection fraction(HFpEF)after percutaneous coronary intervention(PCI)and its effect on serum galectin 3(Gal-3)and soluble oncogenic inhibitor 2(sST2).Methods:A total of 86 patients with HFpEF after PCI were randomly divided into two groups:the control group(n=43)received conventional western medicine treatment,and the observation group(n=43)was treated with Xinshuai Baoyuan decoction on the basis of the control group,and the course of treatment was 12 weeks.The clinical efficacy of the two groups was recorded,and the relevant cardiac function indexes,echocardiographic indicators,serum Gal-3 and sST2 levels were compared between the two groups before and after treatment.Results:The total clinical effective rate of observation group was higher than control group(P<0.05).Compared with before treatment,Lee’s heart failure score,NYHA grade,serum N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular mass index(LVMI)were significantly reduced in the two groups after treatment(P<0.05),and the reduction degree in the observation group was higher than that in the control group(P<0.05).The peak blood flow(E/A)of advanced mitral valve increased(P<0.05),and the increase degree in the observation group was higher than that in the control group(P<0.05).Compared with before treatment,the serum levels of Gal-3 and sST2 in the two groups were significantly decreased after treatment(P<0.05),and the reduction degree in the observation group was higher than that in the control group(P<0.05).Conclusion:On the basis of Western medicine treatment,the addition of Xinshuai Baoyuan decoction can effectively improve the clinical efficacy of HFpEF after PCI,inhibit ventricular remodeling,improve cardiac function,and down-regulate the expression levels of serum Gal-3 and sST2,which is conducive to reducing the incide

关 键 词：射血分数保留型心力衰竭 心衰保元汤 经皮冠状动脉介入术 半乳糖凝集素3 可溶性致癌抑制因子2 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]