利尿合剂联合常规疗法治疗慢性心力衰竭的疗效及对患者心功能、血清BNP、H-FABP和Nexilin水平的影响

摘要

目的 观察利尿合剂联合常规疗法治疗慢性心力衰竭(CHF)的疗效及对心功能、血清脑钠肽(BNP)、心型脂肪酸结合蛋白(H-FABP)和微管链接蛋白(Nexilin)水平的影响.方法 选取山西医科大学第二医院2014年2月至2018年2月64例CHF患者为研究对象,按随机数字表法将其分为联合组(在常规疗法的基础上加以利尿合剂治疗)和常规组(仅给予常规疗法治疗),每组32例.比较两组患者的疗效、心功能及心衰相关因子、不良反应.结果 联合组治疗总有效率(90.63％)高于常规组(68.75％,P＜0.05);治疗后,两组患者的左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)均降低(P＜0.05),左室射血分数(LVEF)、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(E/A)及6 min行走距离(6MWT)均升高(P＜0.05),且联合组上述指标变动幅度均大于常规组(P＜0.05);治疗后,两组患者的BNP、H-FABP、Nexilin、超敏C反应蛋白(hs-CRP)及心肌肌钙蛋白(cTnI)均降低(P＜0.05),且联合组上述指标均低于常规组(P＜0.05);联合组不良事件总发生率(12.50％)与常规组(6.25％)比较,差异未见统计学意义(P＞0.05).结论 利尿合剂联合常规疗法可改善CHF患者的疗效和心功能,降低心衰程度,安全性良好.%Objective To observe the efficacy of diuretic mixture combined with conventional therapy on chronic heart failure (CHF) and its influence on cardiac function and levels of serum brain natriuretic peptide (BNP),heart-type fatty acid binding protein (H-FABP) and Nexilin.Methods Sixty-four CHF patients in the Second Hospital of Shanxi Medical University form February 2014 to February 2018 were selected as the research subjects.They were divided into two groups by random number table,the combined group (treated with diuretic mixture on the basis of routine therapy) and the routine group (treated with routine therapy only),32 cases in each group.The efficacy,cardiac function and heart failure related factors and adverse reactions between the two groups were compared.Results The total effective rate in the combined group (90.63％) was significantly higher than that in the conventional group (68.75％,P＜0.05).After treatment,the LVESD and LVEDD were significantly decreased in the two groups (P＜0.05);while the LVEF,E/A and 6MWT were significantly increased (P ＜ 0.05),and the changes of the above indexes in the combined group were greater than those in the conventional group (P ＜ 0.05).After treatment,the levels of BNP,H-FABP,Nexilin,hs-CRP and cTnI were significantly decreased in the two groups (P ＜0.05),and the above indexes in the combined group were lower than those in the conventional group (P ＜0.05).The total incidence rate of adverse events in the combined group was not significantly different from that in the conventional group (12.50％ vs.6.25％) (P ＞0.05).Conclusions Diuretics combined with conventional therapy can improve the efficacy and cardiac function of patients with CHF,and reduce the degree of heart failure,and it has good safety.