目的 探討生脈注射液聯(lián)合托拉塞米片治療慢性心力衰竭的臨床療效。方法 選擇2020年6月-2022年8月在空軍第九八六醫(yī)院就診的88例慢性心力衰竭患者,依據(jù)隨機數(shù)字表法將全部患者分為對照組和治療組,每組各44例。對照組口服托拉塞米片,1片/次,1次/d。治療組在對照組基礎(chǔ)上靜脈滴注生脈注射液,每次劑量40mL加入5%葡萄糖注射液250mL中,1次/d。兩組患者連續(xù)治療14 d。觀察兩組患者臨床療效,比較治療前后兩組患者6 min步行實驗(6 MWT)、心功能、心率變異性、B型利鈉肽原(proBNP)、血小板平均體積(MPV)、紅細胞分布寬度(RDW)。結(jié)果 治療后,治療組的總有效率為95.45%,明顯高于對照組的總有效率81.82%,組間差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組的6 MWT均明顯增大(P<0.05),治療組的6 MWT較對照組增大更明顯(P<0.05)。治療后,兩組左室射血分數(shù)(LVEF)明顯增大,左室收縮末期內(nèi)徑(LVDS)明顯減小(P<0.05);治療后治療組的LVEF高于對照組,LVDS低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組的竇性間期平均值(SDANN)、竇性間期標(biāo)準差(SDNN)、相鄰竇性間期差的變異系數(shù)(RMSSD)均明顯升高(P<0.05),且治療組的SDANN、SDNN、RMSSD高于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組的血清proBNP、MPV、RDW均明顯低于治療前(P<0.05),且治療組的血清proBNP、MPV、RDW明顯低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 生脈注射液聯(lián)合托拉塞米片治療慢性心力衰竭的療效確切,能改善心功能和心率變異性,降低血清proBNP、MPV、RDW。

Objective To investigate the clinical efficacy of Shengmai Injection combined with Torsemide Tablets in treatment of chronic heart failure. Methods Patients (88 cases) with chronic heart failure in 986 Air Force Hospital from June 2020 to August 2022 were divided into control and treatment groups according to random number table method, and each group had 44 cases. Patients in the control group were po administered with Torsemide Tablets, 1 tablet/time, once daily. Patients in the treatment group were iv administered with Shengmai Injection on the basis of the control group, 40 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the 6 MWT, cardiac function, heart rate variability, proBNP, and MPV, RDW in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.45%, which was significantly higher than that of the control group (81.82%), with a statistically significant difference (P＜0.05). After treatment, the 6 MWT in two groups were significantly increased (P＜0.05), and the 6 MWT in the treatment group was significantly longer than that in the control group (P＜0.05). After treatment, LVEF in two groups were significantly increased, but LVDS in two groups significantly decreased (P＜0.05); After treatment, LVEF in the treatment group was higher than that in the control group, but LVDS in the treatment group was lower than that in the control group, with a statistically significant difference (P＜0.05). After treatment, SDANN, SDNN, and RMSSD in two groups were significantly increased (P＜0.05), and the SDANN, SDNN, and RMSSD in the treatment group were higher than those in the control group, with a statistically significant difference (P＜0.05). After treatment, the proBNP, MPV, and RDW of two groups were significantly lower than those before treatment (P＜0.05), and the proBNP, MPV, and RDW of the treatment group were significantly lower than those of the control group (P＜0.05). Conclusion Shengmai injection combined with Torsemide Tablets is effective in treatment of chronic heart failure, which can improve clinical efficacy, improve cardiac function and heart rate variability, and reduce the levels of proBNP, MPV and RDW.

R972

陜西省自然科學(xué)基礎(chǔ)研究計劃項目(2021JM-230)