老年充血性心力衰竭与氧自由基、脑钠素的关系及川芎嗪干预效果研究

目的观察川芎嗪治疗老年充血性心力衰竭（CHF）的效果及对氧自由基（OFR）和脑钠素（BNP）的影响。方法选择45例正常对照组及90例老年CHF患者，并随机分为常规治疗组和川芎嗪组，两组共治疗4周，对照组及两组患者治疗前后进行血清超氧化物歧化酶（SOD）、过氧化氢酶（CAT）、丙二醛（MDA）、过氧化脂质（LPO）及BNP水平进行测定，并观察两组CHF病人治疗前后NYHA分级及心功能指标的变化。结果常规治疗组、川芎嗪组治疗前SOD，CAT水平明显低于正常对照组（P〈0．01）；MDA，LPO，BNP明显高于正常对照组（P〈0．01）；川芎嗪组治疗后SOD，CAT水平明显高于治疗前及常规治疗组（P〈0．01）；MDA，LPO，BNP明显低于治疗前及常规治疗组（P〈0．01）；两组CHF病人治疗后NYHA分级及心功能指标均得到显著改善（P〈0．01），但川芎嗪组较常规治疗组改善更明显（P〈0．01）。结论川芎嗪有明显的抗氧化作用，并能降低BNP水平，从而改善CHF患者的心功能，血浆BNP，SOD，CAT，MDA，LPO浓度为心力衰竭严重程度、判断疗效的敏感指标，值得临床推广和应用。

The Study of the Effect of Chuanxiongzine on the Oxygen Free Radicals and Brain Natriuretic Peptide in Old Patients with Congestive Heart Failure

Objective To study the effect of Chuanxiongzine in treating congestive heart failue in aged people,and its effects of anti-oxygen free radicals. Methods Choosing 45 cases as the normal control group,90 eases as the CHF group randomly divided into 2 subgroups. Standard therapy group （ n = 43 ） were treated with cardiac tonic, diuretic and angiotensin-converting enzyme inhibitor （ ACEI ）. Chuanxiongzine group（ n = 47 ） were treated with Chuanxiongzine as well as the above routine therapy. After 4 weeks,the changes of superoxide dismutase（SOD） ,CAT, MDA,LPO and BNP were detected in the two groups. Results ①Before treatment the levels of SOD and CAT in regular treatment group and Chuanxiongzine group were significantly lower compared with the normal control group（ P 〈 0.01 ） , while the levels of MDA,LPO and BNP were significantly higher（ P 〈 0.01 ）.②Compared with pre-treatment and standard treatment group, the levels of SOD and CAT in Chuanxiongzine group were significantly higher（ P 〈0.01 ） ,while the levels of MDA,LPO and BNP were significantly lower（ P 〈 0.01 ）. ③ After treatment,the class of NYHA and cardiac function were both improved in two groups （ P 〈 0.01 ） , while the change in the Chuanxiongzine group was more obvious（ P 〈 0.01 ）. Conclusion Anti-oxidant action of Chuanxiongzine was significant and it can reduce the level of BNP,thus improve the cardiac function in CHF patients. The serum level of BNP, SOD, CAT, MDA, LPO could be used in clinic as sensitive marks to estimate the degree of severity in CHF patients.