参附注射液对急性心肌梗死合并心力衰竭患者心功能的改善作用及疗效分析

摘要

目的：研究参附注射液对急性心肌梗死合并心力衰竭患者心功能的改善作用及疗效。方法选取2010年8月至2015年3月东风汽车公司茅箭医院收治的急性心肌梗死合并心力衰竭患者46例，按照投硬币法分为观察组和对照组，各23例。对照组采用抗血小板聚集、抗凝、吸氧等常规治疗，观察组在此基础上将浓度为5％的葡萄糖200 mL和40 mL 参附注射液稀释后静脉滴注，每日1次。比较患者治疗前后心功能指标、肿瘤坏死因子α（ TNF-α）、一氧化氮（ NO）、高敏C反应蛋白（ hs-CRP）、血浆脑钠肽变化情况，评价患者临床疗效。结果治疗后，观察组的心率低于对照组[（87．43±8．55）次／min 比（98．32±9．35）次／min]，心脏指数、心排血量、左心室射血分数（LVEF）显著高于对照组[（2．72±0．57） L／（min・ m2）比（2．18±0．56） L／（min・ m2）、（4666±211） mL／min比（3499±130） mL／min、（63．54±6．78）％比（56．83±6．21）％]，差异有统计学意义（P ＜0．05）。观察组的TNF-α、hs-CRP、脑钠肽显著低于对照组[（1．18±0．14）μg／L 比（2．02±0．21）μg／L、（23±3） g／L比（34±3） g／L、（187±12） ng／L 比（256±14） ng／L]，NO 显著高于对照组[（60±6） mmol／L 比（55±5） mmol／L]，差异有统计学意义（P ＜0．05）。观察组总的有效率显著高于对照组[91．30％（20／23）比65．22％（15／23），P ＜0．05]。两组患者的并发症发生率差异无统计学意义（P＞0．05）。结论参附注射液治疗急性心肌梗死合并心力衰竭患者，能明显改善患者的心功能和临床症状，疗效良好。%Objective To study the Shenfu injection improvement on cardiac function and curative effect for patients of acute myocardial infarction with heart failure .Methods Total of 46 patients with acute myocardial infarction complicating heart failurein Maojian Hospital of Dongfeng Motor Corporation from Aug . 2010 to Mar.2015 were included in the study,according to the coin method,they were divided into an obser-vation group and a control group,23 cases in each group.The control group was given anti-platelet aggrega-tion,anticoagulation,oxygen and other conventional treatments,and the observation group was added with 5%glucose 200 mL and 40 mL of ginseng injection diluted by static drop,1 time/day.The cardiac function index,tumor necrosis factor alpha(TNF-α),nitric oxide (NO),high sensitive C-reactive protein(hs-CRP) and plasma brain natriuretic peptide( BNP) changes before and after treatment were compared.And the clini-cal efficacy was evaluated.Results After treatment,the heart rate of the observation group was lower than the control group[(87.43 ±8.55) times/min vs (98.32 ±9.35) times/min],cardiac index and cardiac output and left ventricular ejection fraction ( LVEF ) were significantly higher than the control group [(2.72 ±0.57) L/(min・ m2) vs (2.18 ±0.56) L/(min・ m2),(4666 ±211) mL/min vs (3499 ± 130) mL/min,(63.54 ±6.78)% vs (56.83 ±6.21)%],the differences were statistically significant(P<0.05).TNF-α,hs-CRP,BNP of the observation group were obviously lower than the control group[(1.18 ± 0.14) μg/L vs (2.02 ±0.21) μg/L,(23 ±3) g/L vs (34 ±3) g/L,(187 ±12) ng/L vs (256 ±14) ng/L],NO was higher than the control group[(60 ±6) mmol/L vs (55 ±5) mmol/L],the differences were statistically significant( P<0.05) .The total effective rate of the observation group was significantly higher than control group [91.30% (20/23) vs 65.22% (15/23),P<0.05].The incidence of complications had no signifi-cant difference between the two groups(P>0.05).Conclusion Shenfu injection treatment for patients with acute myocardial infarction complicating heart failure can significantly improve the patient′s cardiac function and clinical symptoms,with good curative effect.