参脉注射液联合左卡尼汀对老年肺心病心力衰竭期心功能及血清 Copeptin、NT-proBNP、hs-cTnT 的影响

摘要

目的：探讨参麦注射液联合左卡尼汀对慢性肺源性心脏病（ CPHD）心力衰竭期心功能及血清和肽素（Copeptin）、N末端脑利钠肽前体（NT-proBNP）、高敏心肌肌钙蛋白T（hs-cTnT）水平的影响及其机制。方法选取2013年1月—2014年10月河北北方学院附属第一医院老年科收治的 CPHD心力衰竭期患者110例，按随机数字表法分为观察组和对照组各55例，2组均给予吸氧、祛痰平喘、强心、利尿剂、扩血管等常规治疗，对照组加用左卡尼汀3 g，1次／d，连续治疗3周，观察组在对照组基础上加用参麦注射液100 ml静脉滴注，1次／d，连续治疗3周。观察2组治疗前后心功能、血清Copeptin、NT-proBNP、hs-cTnT水平的变化。结果观察组总有效率为94摀．55％（52／55），高于对照组的83．64％（46／55）（ P ＜0．05）。2组在治疗前各项观察指标比较差异无统计学意义（ P ＞0．05），治疗3周后E峰、Ve、E／A、Ve／Va明显升高，A峰、Va明显降低，但观察组变化更显著（ P均＜0．05）；治疗后2组PaO2、PaCO2均改善，血清Copeptin、NT-proBNP、hs-cTnT较治疗前明显下降，且观察组下降更明显（ P均＜0．05）。结论参麦注射液联合左卡尼汀能明显改善CPHD心力衰竭期患者心功能，降低血清Copeptin、NT-proBNP、hs-cTnT水平，且用药安全。%Objective To discuss the effect of Shenmai injection combined with L-carnitine on chronic pulmonary heart disease (CPHD) of heart failure and cardiac function and serum peptide hormone (Copeptin), N-terminal brain natri-uretic peptide precursor ( NT-proBNP ) , high-sensitivity cardiac muscle troponin T ( hs-cTnT ) levels and its mechanism. Methods Select from January 2013 to October 2014, 110 patients of CPHD with heart failure in the First Affiliated Hospital of Hebei North University, they were randomly divided into observation group and control group with 55 cases in each group, two groups were given oxygen, expectorant asthma, cardiac, diuretic, vasodilator and other conventional treatment, the control group were treated with L-carnitine 3g, 1 times /d, treatment for 3 consecutive weeks, the observation group also added Shenmai injection 100 ml intravenous infusion, 1 times /d, treatment for 3 consecutive weeks.Change of cardiac function, serum Copeptin, NT-proBNP, hs-cTnT level in the two groups were observed before and after treatment.Results All indexes in the 2 groups before treatment showed no statistically significance difference ( P >0.05).Observation group’s total effec-tive rate was 94.55%(52/55), which higher than in the control group of 83.64% (46/55) ( P <0.05);3 weeks after treatment, 2 group’ s E peak, Ve, E /A, Ve /Va significantly higher, A peak, Va decreased, but more significantly in the observation group ( P <0.05);after treatment, the two groups’ PaO2 , PaCO2 were improved, serum Copeptin, NT-proBNP, hs-cTnT were significantly decreased than before treatment, and the observation group decreased more significantly ( P <0.05).Conclusion Shenmai injection combined with L-carnitine can improve heart function in patients with heart failure CPHD, decrease serum Copeptin, NT-proBNP, hs-cTnT level with drug safety.