丹参酮注射液联合无创正压通气治疗急性左心衰竭的疗效及对心功能和炎症反应的影响
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摘要
目的观察丹参酮注射液联合无创正压通气治疗急性左心衰竭的临床疗效及对血流动力学、心功能和炎症反应水平的影响。方法选取我院收治的急性左心衰竭病人128例作为研究对象,按照随机数字表法分为对照组和观察组,各64例。两组均给予常规治疗,在此基础上对照组给予无创正压通气治疗,观察组在对照组基础上联合丹参酮注射液治疗。观察两组平均动脉压(MAP)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2),检测心排血量(CO)、每搏量(SV)、心脏指数(CI)、外周血管阻力(SVR)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)以及左心室射血分数(LVEF)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、 N末端脑钠肽原(NT-proBNP)水平,并比较两组临床疗效。结果治疗后两组MAP、PaCO_2水平明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05);PaO_2水平明显高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。观察组总有效率为93.75%,高于对照组的81.25%(P<0.05)。治疗后两组CO、SV、CI水平明显高于治疗前(P<0.05),且观察组高于对照组(P<0.05);SVR水平明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05);治疗后两组LVEDD、LVESD水平明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05);LVEF水平明显高于治疗前(P<0.05),且观察组高于对照组(P<0.05);治疗后两组hs-CRP、IL-6、NT-proBNP水平明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。结论丹参酮注射液联合无创正压通气可有效改善急性左心衰竭病人心功能和血流动力学,降低血清炎症因子水平,提高临床疗效。
Objective To observe the influence of Tanshinone injection combined with non-invasive positive pressure ventilation in acute left heart failure.Method One hundred and twenty eight patients with acute left heart failure were selected and divided into control group and observation group randomly, with 64 cases in each group.All patients were given routine treatment,patients in the control group received non-invasive positive pressure ventilation treatment,while patients in the observation group received Tanshinone injection treatment based on that of the control group.Mean arterial pressure(MAP),arterial partial pressure(PaO_2), partial pressure of carbon dioxide(PaCO_2),clinical efficacy,cardiac output(CO), stroke volume(SV),cardiac index(CI),peripheral vascular resistance(SVR),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF), high sensitive C reactive protein(hs-CRP) and interleukin-6(IL-6), N terminal brain natriuretic peptide(NT-proBNP) levels were compared between two groups.Results After treatment, MAP and PaCO_2 level was significantly lower than that before treatment(P<0.05),which were lower in the observation group than that in the control group(P<0.05).PaO_2 levels were significantly higher than those before treatment(P<0.05), and those in the observation group were significantly higher than those in the control group(P<0.05).Total efficiency of the observation group was significantly higher than that of the control group(93.75% vs. 81.25%,P<0.05). After treatment, CO, SV,and CI levels were significantly higher than those before treatment(P<0.05), and those in the observation group were significantly higher than those in the control group(P<0.05).SVR level was significantly lower than that before treatment(P<0.05), and that in the observation group was significantly lower than that in the control group(P<0.05). After treatment, LVEDD and LVESD levels were significantly lower than those before treatment(P<0.05), and those in the observation group were significantly lower than those in the control group(P<0.05).LVEF was significantly higher than that before treatment in the two groups(P<0.05), and that in the observation group was significantly higher than that in the control group(P<0.05).After treatment, hs-CRP, IL-6,and NT-proBNP levels were significantly lower than those before treatment in the two groups(P<0.05), and those in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Tanshinone injection combined with non-invasive positive pressure ventilation can effectively improve cardiac function and hemodynamics of patients with acute left heart failure, reduce the levels of serum inflammatory factors and improve clinical curative effect.
Objective To observe the influence of Tanshinone injection combined with non-invasive positive pressure ventilation in acute left heart failure.Method One hundred and twenty eight patients with acute left heart failure were selected and divided into control group and observation group randomly, with 64 cases in each group.All patients were given routine treatment,patients in the control group received non-invasive positive pressure ventilation treatment,while patients in the observation group received Tanshinone injection treatment based on that of the control group.Mean arterial pressure(MAP),arterial partial pressure(PaO_2), partial pressure of carbon dioxide(PaCO_2),clinical efficacy,cardiac output(CO), stroke volume(SV),cardiac index(CI),peripheral vascular resistance(SVR),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF), high sensitive C reactive protein(hs-CRP) and interleukin-6(IL-6), N terminal brain natriuretic peptide(NT-proBNP) levels were compared between two groups.Results After treatment, MAP and PaCO_2 level was significantly lower than that before treatment(P<0.05),which were lower in the observation group than that in the control group(P<0.05).PaO_2 levels were significantly higher than those before treatment(P<0.05), and those in the observation group were significantly higher than those in the control group(P<0.05).Total efficiency of the observation group was significantly higher than that of the control group(93.75% vs. 81.25%,P<0.05). After treatment, CO, SV,and CI levels were significantly higher than those before treatment(P<0.05), and those in the observation group were significantly higher than those in the control group(P<0.05).SVR level was significantly lower than that before treatment(P<0.05), and that in the observation group was significantly lower than that in the control group(P<0.05). After treatment, LVEDD and LVESD levels were significantly lower than those before treatment(P<0.05), and those in the observation group were significantly lower than those in the control group(P<0.05).LVEF was significantly higher than that before treatment in the two groups(P<0.05), and that in the observation group was significantly higher than that in the control group(P<0.05).After treatment, hs-CRP, IL-6,and NT-proBNP levels were significantly lower than those before treatment in the two groups(P<0.05), and those in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Tanshinone injection combined with non-invasive positive pressure ventilation can effectively improve cardiac function and hemodynamics of patients with acute left heart failure, reduce the levels of serum inflammatory factors and improve clinical curative effect.
引文
[1] 杨柳青.参附注射液联合无创正压通气对急性左心衰竭患者呼吸功能的影响[J].山西中医,2017,33(6):32-33.
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[8] 高勇.重组人脑利钠肽对急性心力衰竭患者血流动力学、心功能和免疫功能的影响[J].医药论坛杂志,2014,35(11):142-143.
[9] 刘宏伟.无创正压通气治疗重度急性左心衰效果观察[J].菏泽医学专科学校学报,2016,28(1):40-41;49.
[10] 张玥.益气化瘀冲剂治疗慢性收缩性心力衰竭气虚血瘀证102例[J].河南中医,2014,34(5):850-851.
[11] 肖毅.无创正压通气治疗老年急性左心衰患者的临床疗效观察[J].海南医学院学报,2011,17(3):355-357.
[12] 盖宇.ICU无创正压通气治疗急性左心衰40例的疗效观察[J].中国现代药物应用,2013,7(22):27-28.
[13] 孙贺元,傅强.无创机械通气治疗早期急性左心衰心输出量观察[J].天津医科大学学报,2014,20(5):370-373.
[14] 邢志敏,张岚.参麦宁心合剂治疗冠心病心力衰竭临床研究[J].中医学报,2012,27(2):213-214.
[15] 徐宁,唐海沁,张亚文.芪苈强心胶囊治疗慢性心力衰竭疗效分析[J].世界中医药,2014,9(2):237-241.
[16] 崔振川,王宏斌.托拉塞米和丹参酮ⅡA磺酸钠治疗慢性充血性心力衰竭的疗效比较[J].现代药物与临床,2016,31(12):1909-1912.
[17] 王茜,闵新文,李东峰,等.丹参酮ⅡA磺酸钠对急性心力衰竭患者血流动力学和血管内皮功能的影响[J].实用心脑肺血管病杂志,2016,24(6):82-85.
[2] 叶海英,蒋爱忠,黄少伦.双水平无创正压通气治疗急性左心衰的临床疗效观察[J].中国医学工程,2015,23(8):69-71.
[3] 乔春英.丹参酮ⅡA磺酸钠注射液治疗心力衰竭临床观察[J].青海医药杂志,2017,47(2):13-14.
[4] 中华医学会心血管病学分会.急性心力衰竭诊断和治疗指南[J].中国医刊,2010,38(8):85-89.
[5] 中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:228-229.
[6] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:1.
[7] 杨光全.重组人脑利钠肽对慢性心力衰竭患者心功能和心肌损伤的影响[J].中国现代药物应用,2017,11(8):4-6.
[8] 高勇.重组人脑利钠肽对急性心力衰竭患者血流动力学、心功能和免疫功能的影响[J].医药论坛杂志,2014,35(11):142-143.
[9] 刘宏伟.无创正压通气治疗重度急性左心衰效果观察[J].菏泽医学专科学校学报,2016,28(1):40-41;49.
[10] 张玥.益气化瘀冲剂治疗慢性收缩性心力衰竭气虚血瘀证102例[J].河南中医,2014,34(5):850-851.
[11] 肖毅.无创正压通气治疗老年急性左心衰患者的临床疗效观察[J].海南医学院学报,2011,17(3):355-357.
[12] 盖宇.ICU无创正压通气治疗急性左心衰40例的疗效观察[J].中国现代药物应用,2013,7(22):27-28.
[13] 孙贺元,傅强.无创机械通气治疗早期急性左心衰心输出量观察[J].天津医科大学学报,2014,20(5):370-373.
[14] 邢志敏,张岚.参麦宁心合剂治疗冠心病心力衰竭临床研究[J].中医学报,2012,27(2):213-214.
[15] 徐宁,唐海沁,张亚文.芪苈强心胶囊治疗慢性心力衰竭疗效分析[J].世界中医药,2014,9(2):237-241.
[16] 崔振川,王宏斌.托拉塞米和丹参酮ⅡA磺酸钠治疗慢性充血性心力衰竭的疗效比较[J].现代药物与临床,2016,31(12):1909-1912.
[17] 王茜,闵新文,李东峰,等.丹参酮ⅡA磺酸钠对急性心力衰竭患者血流动力学和血管内皮功能的影响[J].实用心脑肺血管病杂志,2016,24(6):82-85.