参附注射液对尿毒症心肌病并心功能衰竭患者的疗效观察

目的：探讨参附注射液治疗尿毒症心肌病并心功能衰竭患者的临床疗效。方法：筛选40例尿毒症心肌病并心功能衰竭患者，分为常规组20例，实验组20例，观察实验组20例尿毒症心功能衰竭行维持性血液透析患者在常规综合治疗基础上加用参附注射液治疗后的心脏左室收缩功能改善情况，共2个疗程14d，并观察治疗前后两组患者N末端B型利钠肽原（NT-proBNP）、C-反应蛋白（CRP）及心脏大小改善情况。结果：治疗后实验组患者左室射血分数（LVEF）、短缩分数（FS）和每搏量（SV，m1）均较治疗前明显改善（均P〈0．05），且与常规组相比较，差异亦有统计学意义（均P〈0．05）。实验组NT—proBNP和CRP水平较前明显降低，差异有统计学意义（均P〈0．05），与常规组相比较，差异亦有统计学意义（均P〈0．05）。治疗前后两组患者心脏结构指标（LAD、LVDd、LVDs、IVST、LVPWT）值相比较，差异无统计学意义（P〉0．05）。结论：尿毒症心肌病并心功能衰竭患者存在泵血功能衰竭和微炎症状态，参附注射液通过改善心肌收缩力和微炎症状态，从而改善尿毒症患者心功能和临床症状。

The efficacy of Shenfu injection on the uremic cardiomyopathy combined with heart failure patients

Objective：To investigate the treatment of Shenfu injection on the uremic cardiomyopathy combined with heart failure patients.Method：40cases of uremic cardiomyopathy combined with heart failure patients were divided into two groups：conventional group and experimental group,each group had 20 cases.The 20 cases of experimental group were treated by maintenance hemodialysis、conventional treatment and Shenfu injection,the conventional group were only treated by maintenance hemodialysis and conventional treatment,the total of two courses for 14 days.The improvement situation of cardiac left ventricular systolic function、N-terminal B-type natriuretic peptide（NT-proBNP）、C-reactive protein（CRP）and cardiac structural indicators were observed before and after treatment.Result：After two courses of treatment,the left ventricular ejection fraction（LVEF）,fractional shortening（FS）and stroke volume（SV,ml）of experimental group were significantly improved（P0.05）,and compared with the conventional group,the difference was statistically significant（P0.05）.The N-terminal B-type natriuretic peptide and C-reactive protein levels were significantly lower than before（P0.05）,and compared with the conventional group,the difference was also statistically significant（P0.05）.The cardiac structural indicators（LAD,LVDd,LVDs,IVST,LVPWT）of two groups were not improved before and after treatment,the difference was not statistically significant（P0.05）.Conclusion：The patients of uremic cardiomyopathy and heart failure always had pumping failure and micro-inflammatory state,Shenfu injection could improve the myocardial contractility and micro-inflammatory state,thereby improve the cardiac function and clinical symptoms.