参麦注射液联合米力农治疗难治性心力衰竭疗效观察

目的探讨参麦注射液联合米力农治疗难治性心力衰竭的临床效果。方法选择难治性心力衰竭患者92例,依据随机数字的方法分为对照组46例和观察组46例,患者入院后均常规治疗,对照组给予米利农治疗,观察组在对照组治疗方法基础上给予参麦注射液。对两组治疗前后的心型脂肪酸结合蛋白(H-FABP),血浆心肌肌钙蛋白Ⅰ(cTnⅠ),氨基末端B型钠尿肽原(NT-proBNP),心率(HR),左心室射血分数(LVEF),每搏输出量(SV)进行对比。对两组的临床治疗效果进行对比。对两组治疗过程中的不良反应对比。结果经过治疗后,对照组的H-FABP从(17.23±3.51)ng/L降低到(15.11±3.12)ng/L,NT-proBNP从(8.13±2.32)μg/L降低到(6.51±1.45)μg/L,cTnⅠ从(31.25±5.01)ng/L降低到(23.81±4.25)ng/L,观察组的H-FABP从(16.97±3.78)ng/L降低到(9.91±3.01)ng/L,NT-proBNP从(8.21±1.98)μg/L降低到(4.13±1.34)μg/L,cTnⅠ从(32.07±5.23)ng/L降低到(18.81±5.12)ng/L,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=8.135,8.176,5.096,P<0.05),经过治疗后,对照组的HR从(135.26±10.51)次/min降低到(103.81±9.81)次/min,LVEF从(32.41±5.41)%升高到(38.31±4.87)%,SV从(37.91±2.71)mL升高到(43.23±3.47)mL,观察组的HR从(134.81±11.28)次/min降低到(95.31±9.97)次/min,LVEF从(31.87±5.37)%升高到(43.21±4.25)%,SV从(38.11±3.13)mL升高到(50.91±3.68)mL,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=4.122,-5.142,-10.298,P<0.05),观察组的治疗效果优于对照组,数据差异具有统计学意义(z=-4.994,P<0.05),两组的恶心4.35%(2/46)VS. 2.17%(1/46)],血压低6.52%(3/46)VS. 4.35%(2/46)],头晕8.70%(4/46)VS. 13.04%(6/46)],乏力15.22%(7/46)VS. 8.70%(4/46)],呕吐4.35%(2/46)VS. 6.52%(3/46)],室性早搏2.17%(1/46)VS. 4.35%(2/46)],发生率数据差异均不具有统计学意义(χ^2=0.000,0.000,0.449,0.929,0.000,0.000,P>0.05)。结论利用参麦注射液联合米力农治疗难治性心力衰竭,可以改善心肌功能,提升治疗效果,安全性良好。

Therapeutic Effect of Shenmai Injection Combined with Milrinone in Treatment of Refractory Heart Failure

Objective To explore the clinical effect of Shenmai Injection combined with milrinone in the treatment of refractory heart failure. Methods Ninety-two patients with refractory heart failure were selected. According to the method of random number, it was divided into control group(n=46) and observation group(n=46). The patients were treated routinely after admission, and the patients in the control group were treated with milrinone. The patients in the observation group were given Shenmai Injection on the basis treatment of the control group. Cardiac fatty acid binding protein(H-FABP), plasma cardiac troponin I(cTnI), amino terminal B-type natriuretic peptide(NT-proBNP), heart rate(HR), left ventricular effusion,blood score(LVEF) and stroke volume(SV) in both groups before and after treatment were compared. The clinical treatment effects of the two groups were compared. We compared adverse reactions during treatment in two groups. Results After treatment, the H-FABP of the control group decreased from(17.23±3.51)ng/L to(15.11±3.12)ng/L, and the NT-proBNP decreased from(8.13±2.32)μg/L to(6.51±1.45)μg/L, cTnI decreased from(31.25±5.01)ng/L to(23.81±4.25)ng/L. The H-FABP of the observation group decreased from(16.97±3.78)ng/L to(9.91±3.01)ng/L, and the NT-proBNP decreased from(8.21±1.98)μg/L to(4.13±1.34)μg/L. The cTnI decreased from(32.07±5.23)ng/L to(18.81±5.12)ng/L. The change of the observation group was larger than that of the control group, and the data was statistically significant(t=8.135, 8.176, 5.096, P<0.05). After treatment, the HR of the control group decreased from(135.26±10.51)times/min to(103.81±9.81)times/min, and LVEF increased from(32.41±5.41)% to(38.31±4.87)%, SV from(37.91±2.71)mL was raised to(43.23±3.47)mL. The HR of the observation group decreased from(134.81±11.28)times/min to(95.31±9.97)times/min, and the LVEF increased from(31.87±5.37)% to(43.21±4.25)%, and SV raised from(38.11±3.13)mL to(50.91±3.68)mL. The change of the observation group was larger than that of the control group, and the data was statistically significant(t=4.122,-5.112,-10.298, P<0.05). The therapeutic effect of the observation group was better than that of the control group, and the data was statistically significant(z=-4.994,P<0.05). Nausea in both groups4.35%(2/46) vs. 2.17%(1/46)], low blood pressure6.52%(3/46) vs. 4.35%(2/46)], dizziness8.70%(4/46) vs. 13.04%(6/46)], fatigue15.22%(7/46) vs. 8.70%(4/46)], vomiting4.35%(2/46) vs. 6.52%(3/46)] and premature ventricular contractions2.17%(1/46) vs. 4.35%(2/46)] were not statistically significant(χ^2=0.000, 0.000, 0.449, 0.929, 0.000, 0.000,P>0.05). Conclusion Using Shenmai Injection combined with milrinone in the treatment of refractory heart failure can improve myocardial function, treatment effect and have good safety. It is worthy of clinical promotion.