麝香保心丸对慢性充血性心力衰竭患者血浆钠尿肽水平影响.docVIP

麝香保心丸对慢性充血性心力衰竭患者血浆钠尿肽水平影响 　　【摘要】 目的 通过检测钠尿肽(brain natriuretic peptide，BNP)水平的变化观察麝香保心丸对慢性充血性心力衰竭的疗效。方法 将86例心功能NYHA Ⅱ~Ⅳ级的患者随机分为两组，治疗组（46例）在常规抗心衰治疗（包括利尿剂、血管紧张素转换酶抑制剂、β阻滞剂和地高辛等）的基础上给予中药麝香保心丸治疗（2粒/次，2次/d，疗程12周），对照组（40例）仅给予常规治疗。应用竞争酶免疫分析法对治疗前后患者血浆BNP进行分析比较。结果 两组BNP均有显著下降(?P?0.01)，其中治疗组下降较对照组更加明显(?P?0.05)。结论 麝香保心丸可显著降低慢性心力衰竭患者的血浆BNP水平，可用于心力衰竭的长期治疗。? 　　【关键词】 麝香保心丸； 慢性充血性心力衰竭； 钠尿肽?? 　　The level changes of plasma of brain natriuretic peptides in evaluation of Shexiangbaoxin Pill in therapeutic of congestive heart failure ?ZHANG Yu-hua,GUO Jun-yan,YANG Xue-jun,CHEN Jin-liang. The Fourth People?s Hospital of Xinxiang City,Xinxiang 453000,China?? 　　【Abstract】 Objective To evaluate the level changes of plasma of brain natriuretic peptides (BNP) in patients with chronic congestive heart failure (CHF) and the effect of Shexiangbaoxin Pill on CHF.Methods The 86 patients with CHF were divided into two groups:therapy group and control group.Plasma levels of BNP was with competitive enzyme immunoradiometric assay.The patients in the therapy group(?n?=46) were given Shexiangbaoxin Pill for 12 weeks.All of two groups were given diuretic，receiving ACEI,β blocker or digoxin.The therapeutic effects were assessed by change of plasma levels of BNP.Results After treatment，BNP plasma levels both decreased significantly(?P?0.01).The BNP plasma levels decreased more significantly(?P?0.05) in therapy group.Conclusion Shexiangbaoexin Pill could decrease the level of plasma BNP in patients with CHF,and has obvious effects in CHF patients.? 　　【Key words】 Shexiangbaoxin Pill； Chronic heart failure； Brain netriuretic peptides 　　?? 　　 　　麝香保心丸一般认为主要用于心绞痛的治疗，而在用于治疗慢性充血性心力衰竭(CHF)中的远期预后，临床表现很难预示治疗效果，不能单从症状改善上评价药物治疗效果。目前已知CHF患者血液中钠尿肽(BNP)增加［1］，笔者通过对CHF患者治疗前后BNP水平的检测，旨在评价麝香保心丸对CHF的治疗效果，现报告如下。? 　　1 资料与方法? 　　1.1 一般资料 选择2009年1月~2010年10月本院心内科CHF患者86例，其中男59例，女27例，年龄37~81岁，平均（61.3±9.6）岁，随机分为治疗组与对照组，治疗组46例，其中男30例，女16例，年龄42～81岁，平均（61.9±10.3）岁；对照组40例，其中男29例，女11例，年龄37～80岁，平均（60.6±9.6）岁。病因分别为冠心病、高血压心脏病和扩张型心