稳心颗粒联合西药对老年慢性心力衰竭患者血浆AngⅡ、NT －proBNP 及心功能的影响

摘要

目的：观察稳心颗粒联合西药对老年慢性心力衰竭（ CHF）患者血浆血管紧张素Ⅱ（ AngⅡ）、N末端B型钠尿肽原（ NT－proBNP）及心功能的影响。方法将126例老年CHF患者随机分为稳心颗粒组及对照组，对照组给予常规西药治疗，稳心颗粒组在对照组治疗基础上给予稳心颗粒治疗，2组均连续治疗12周。观察2组治疗前及治疗后6周、12周血浆AngⅡ、NT－proBNP水平及心功能相关指标；记录治疗前后心功能NYHA分级情况；并在以上时间点进行6 min步行试验（6MWT）及明尼苏达心力衰竭生活质量问卷（ MLHFQ）评定。结果2组治疗后6周、12周血浆AngⅡ、NT－proBNP水平及左室射血分数、心功能NYHA分级、6MWT距离及MLHFQ积分均较治疗前明显改善（P均＜0．05），且稳心颗粒组改善情况明显优于对照组（P均＜0．05）；2组治疗后6周左室舒张末期内径较治疗前明显改善，但2组间比较差异无统计学意义（P＞0．05）；2组治疗后12周LVEF、LVEDD、LVESD、E／A均明显改善（P均＜0．05），且稳心颗粒组改善情况优于对照组（P均＜0．05）。2组治疗期间均未出现严重的不良反应。结论稳心颗粒能够在一定程度上抑制老年CHF患者的神经内分泌激活，改善患者的心功能，提高心力衰竭患者的生活质量，值得临床推荐。%Objective It is to observe the effect of Wenxin granule combined with western medicine on plasma AngII , NT-proBNP and heart function in elderly patients with chronic heart failure (CHF).Methods 126 elderly patients with CHF were randomly divided into Wenxin granule group treated with Wenxin granule combined with normal western medicine and control group treated with western medicine only .Both the groups were treated for 12 months.The levels of plasma AngII , NT-proBNP and heart function indexes were observed , and NYHA classification, 6MWT and MLHFQ were evaluated before and 6, 12 weeks after treatment in both groups .Results In 6, 12 weeks after treatment, the levels of plasma AngII, NT-proBNP and LVEF, and NYHA classification, 6MWT and MLHFQ scores were all significantly improved compared with those before treatment in both groups (P<0.05), and the improvements in Wenxin granule group were much better than those in control group (P<0.05).In 6 weeks after treatment, LVEDD was improved significantly in both groups compared with that before treatment, but there was no significant difference between the two groups (P>0.05).In 12 weeks after treatment, LVEF, LVEDD, LVESD, E/A were improved in both groups (P<0.05), and the improvements in Wenxin granule group were better than those in control group (P<0.05).No serious side effect was found in both groups during treatment .Conclusion Wenxin granule can partly inhibit activation of neurohormone , improve heart function and life quality of patients with CHF , it is worthy of popularization and application .