黄芪治疗扩张性心肌病患者室性心律失常临床的研究(已改).doc

口服黄芪合剂治疗扩张型心肌病室性心律失常临床研究Liaoyh27@163.com 摘要： 目的：探讨黄芪合剂对扩张型心肌病室性心律失常长期治疗疗效及相关机制。 方法：选择2009.2.~2010.10.我院门诊和住院部65例稳定性扩张心肌病合并有室性心律失常患者，根据病毒学检查结果分为阳性组（n=36）和阴性组（n=29）两组。在常规治疗基础上，阳性组中有25例接受口服黄芪合剂治疗半年（即P1组），11例拒绝而未接受黄芪口服治疗（即P2组）；阴性组中则分别有18例接受（即N1组）、11例未接受黄芪治疗（即N2组）。治疗前后应用Holter检查观察患者室性心律失常变化、心脏彩色超声多普勒评估心脏左心室舒末内径（LVEDd）和射血分数（LVEF）、ELISA法检测外周血细胞因子IFN-γ、IL-4与TGF-β1水平。 结果：P1和N1组中分别有3例和2例未坚持服用黄芪或失访而退出。与治疗前相比，四组室性心律失常改善率分别为：P1 54.5%（12/22）、P2 18.2%（2/11）、N1 43.8%（7/16）、N2 27.3%（3/11）；P1和N1组LVEDd均有缩小（P0.05）、LVEF均有升高（P0.05），血IFN-γ和TGF-β1水平显著下降（P0.01），而IL-4变化无统计学意义；P2和N2组也有相似表现，但是LVEDd、LVEF和IL-4变化均无统计学意义。 结论：口服黄芪合剂可以有效控制扩张型心肌病室性心律失常，其机制可能与降低患者IFN-γ和TGF-β水平、抑制心肌纤维化有关。 关键词：黄芪；扩张型心肌病；心律失常；细胞因子 Treatment of ventricular arrhythmia in dilated cardiomyopathy with Huangqi Department of Cardiology, Institute of Cardiovascular Diseases, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China） Corresponding author: LIAO Yu-Hua, Email: Liaoyh27@163.com Object: To explore the effect of Huangqi on ventricular arrhythmia in dilated cardiomyopathy (DCM). Methods: Sixty-five stable DCM patients with ventricular arrhythmias in our hospital from Feb. 2009 to Oct. 2010 were chose for this study. According to the results of viral detection, all of patients were divided into 2 groups: Positive group (n=36) and Negative group (n=29). On the basis of the regular therapy, 25 cases from Positive group took Huangqi orally for six month (P1 group) while the other 11 cases did not take this medicine (P2 group). And in Negative group, it was 18 cases received the treatment of Huangqi (N1 group) and 11 cases did not (N2 group). Before or after the study, Holter was used to monitor the changes of ventricular arrhythmias, ultrasoundcardiogram (UCG) was employed to investigate Left ventricular end diastolic diameter (LVEDd) and ejection fraction (LVEF), and ELISA was taken to measure the levels of blood cytokines IFN-γ, IL-4 and TGF-β1. Results: There were 3 cases from P1 and 2 cases f