芪苈强心胶囊联合rhBNP治疗急性心肌梗死后心力衰竭的效果观察  

Effect of Qili Qiangxin Capsules combined with rhBNP on heart failure after acute myocardial infarction

作　　者：王淑贤 程俊华 王巧容 WANG Shu-xian;CHENG Jun-hua;WANG Qiao-rong(Department of Cardiovascular Medicine,General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.,Taiyuan Shanxi 030000,China)

机构地区：[1]太原钢铁(集团)有限公司总医院心血管内科,山西太原030000

出　　处：《临床和实验医学杂志》2025年第2期121-125,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省自然科学研究面上项目(编号:202303021211110)。

摘　　要：目的观察芪苈强心胶囊联合重组人脑利钠肽(rhBNP)对急性心肌梗死后心力衰竭的效果。方法前瞻性选取2019年5月至2023年5月太原钢铁(集团)有限公司总医院心血管内科收治的80例急性心肌梗死后心力衰竭患者为研究对象。按照简单数字表法将其分为两组:rhBNP组与联合组,每组各40例。两组给予常规治疗,rhBNP组加用rhBNP治疗,联合组在rhBNP组的基础上联合芪苈强心胶囊治疗。比较两组的治疗前和治疗4周后的心功能[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、心室重构[左心室舒张末期容积(LVEDV)、左心室舒张末期心外膜容积(LVEDVepi)、左心室质量指数(LVMI)、左心室重构指数(LVRI)]、心肌损伤相关指标[肌钙蛋白I(cTnI)、心脏型脂肪酸结合蛋白(H-FABP)、氨基末端B型利钠肽前体(NT-proBNP)、血管紧张素Ⅱ(AngⅡ)、骨膜蛋白]、中医证候评分、Lee氏心衰计分,统计两组的住院时间、不良反应、接受主动脉球囊反博、1年内再入院情况。结果治疗4周后,两组LVEF均较治疗前升高,LVEDD均较治疗前降低,且联合组的LVEF高于rhBNP组,LVEDV低于rhBNP组,差异均有统计学意义(P<0.05)。治疗4周后,两组的LVEDV、LVEDVepi、LVMI均较治疗前降低,LVRI均较治疗前升高,且联合组的LVEDV、LVEDVepi、LVMI均低于rhBNP组,LVRI高于rhBNP组,差异均有统计学意义(P<0.05)。治疗4周后,两组cTnI、H-FABP、NT-proBNP、AngⅡ、骨膜蛋白水平均较治疗前降低,且联合组的cTnI、H-FABP、NT-proBNP、AngⅡ、骨膜蛋白水平均低于rhBNP组,差异均有统计学意义(P<0.05)。治疗4周后,两组中医证候评分、Lee氏心衰计分均较治疗前降低,且联合组的中医证候评分、Lee氏心衰计分均低于rhBNP组,差异均有统计学意义(P<0.05)。联合组住院时间为(9.14±2.56)d,短于rhBNP组[(8.11±2.12)d],差异有统计学意义(P<0.05)。两组的总不良反应发生率、接受主动脉球囊反博发生率、Objective To observe the effect of Qili Qiangxin Capsules combined with recombinant human brain natriuretic peptide(rhBNP)on heart failure after acute myocardial infarction.Methods Eighty patients with heart failure after acute myocardial infarction admitted to the Department of Cardiovascular Medicine,General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.from May 2019 to May 2023 were prospectively selected as the research objects.According to the simple number table method,they were divided into two groups:the rhBNP group and the combination group,with 40 cases in each group.The two groups received conventional treatment,while the rhBNP group received additional treatment with rhBNP.The combination group received treatment with Qili Qiangxin Capsules in addition to the rhBNP group.The heart functions[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],ventricular remodeling[left ventricular end diastolic volume(LVEDV),left ventricular end diastolic epicardial volume(LVEDVepi),left ventricular mass index(LVMI),left ventricular remodeling index(LVRI)],myocardial injury related indexes[cardiac troponin I(cTnI),heart type fatty acid binding protein(H-FABP),N-terminal pro natriuretic peptide(NT-proBNP),angiotensinⅡ(AngⅡ),periosteal protein],traditional Chinese medicine syndrome score,Lee's heart failure score before treatment and after 4 weeks of treatment of the two groups were compared,and the hospitalization time,adverse reactions,acceptance of aortic balloon counterpulsation,and readmission within 1 year of the two groups were counted.Results After 4 weeks of treatment,LVEF in the two groups was higher than that before treatment,LVEDD was lower than that before treatment,and LVEF in the combination group was higher than that in the rhBNP group,LVEDV was lower than that in the rhBNP group,the differences were statistically significant(P<0.05).After 4 weeks of treatment,LVEDV,LVEDVepi and LVMI in the two groups were lower than those before treatment,and LVRI was higher t

关 键 词：急性心肌梗死 心力衰竭 芪苈强心胶囊 重组人脑利钠肽 心室重构 

分 类 号：R54[医药卫生—心血管疾病]