目的 分析冠心舒通膠囊聯(lián)合重組人腦利鈉肽治療慢性心力衰竭的臨床療效。方法 選取2021年1月—2023年11月渭南市中心醫(yī)院收治的122例慢性心力衰竭患者，按隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各61例。對(duì)照組給予凍干重組人腦利鈉肽，先按1.5 μg/kg的劑量靜脈沖擊，繼以0.007 5 μg/(kg∙min)速率持續(xù)靜脈滴注3 d，之后繼續(xù)常規(guī)治療。治療組在此基礎(chǔ)上口服冠心舒通膠囊，3粒/次，3次/d。兩組連續(xù)治療2周。觀察兩組臨床療效，比較治療前后左室射血分?jǐn)?shù)（LVEF）、左室舒張末期容積（LVEDV）、Barthel指數(shù)（BI）評(píng)分、6 min步行距離（6MWD）及心率變異性指標(biāo)[正常心動(dòng)周期標(biāo)準(zhǔn)差（SDNN）、相鄰正常心動(dòng)周期差值的均方根（rMSDD）等]和血清N末端B型利鈉肽原（NT-proBNP）、心肌肌鈣蛋白I（cTnI）、白細(xì)胞介素-6（IL-6）、超敏C反應(yīng)蛋白（hs-CRP）水平。結(jié)果 治療后，治療組總有效率是95.08%，顯著高于對(duì)照組的83.61%（P＜0.05）。治療后，兩組LVEF和BI評(píng)分、6MWD均顯著增加，而LVEDV均顯著減?。?i>P＜0.05）；治療后，LVEF、LVEDV和BI評(píng)分、6MWD以治療組改善更顯著（P＜0.05）。治療后，兩組SDNN、rMSDD、SDANN均顯著升高（P＜0.05），以治療組更顯著（P＜0.05）。治療后，兩組血清NT-proBNP、cTnI、IL-6和hs-CRP水平均顯著下降（P＜0.05），以治療組更顯著（P＜0.05）。結(jié)論 冠心舒通膠囊聯(lián)合重組人腦利鈉肽治療慢性心力衰竭的效果確切，具有較好的安全性，能有效改善患者心臟功能，促進(jìn)生活能力及運(yùn)動(dòng)耐力恢復(fù)，減輕機(jī)體炎性損傷和心肌損害。

Objective To analyze the clinical efficacy of Guanxin Shutong Capsules combined with recombinant human brain natriuretic peptide in treatment of chronic heart failure. Methods A total of 122 patients with chronic heart failure admitted to Weinan Central Hospital from January 2021 to November 2023 were selected and divided into control group and treatment group according to random number table method, with 61 patients in each group. Patients in the control group were given Lyophilized Recombinant Human Brain Natriuretic Peptide, intravenous infusion at a dosage of 1.5 μg/kg was followed by continuous intravenous infusion at a rate of 0.007 5 μg/(kg∙min) for 3 d, after which conventional treatment was continued. Patients in the treatment group were po administered with Guanxin Shutong Capsules on the basis of the control group, 3 capsules/time, 3 times daily. Both groups were treated continuously for 2 weeks. After treatment, the clinical efficacy was evaluated, and the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), Barthel index (BI) score, 6-minute walking distance (6MWD), heart rate variability indicators [standard deviation of normal cardiac cycle (SDNN), root mean square difference between adjacent normal cardiac cycles (rMSDD)], and serum N-terminal B-type natriuretic peptide (NT proBNP), cardiac troponin I (cTnI), interleukin-6 (IL-6), and hypersensitive C-reactive protein (hs CRP) levels before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.08%, which was significantly higher than that of control group (83.61%) (P < 0.05). After treatment, LVEF and BI scores and 6MWD were significantly increased, while LVEDV was significantly decreased in both groups (P < 0.05). After treatment, LVEF, LVEDV, BI scores, and 6MWD were significantly improved in the treatment group (P < 0.05). After treatment, SDNN, rMSDD, and SDANN were significantly increased in both groups (P < 0.05), and more significantly in the treatment group (P < 0.05). After treatment, the levels of serum NT-proBNP, cTnI, IL-6, and hs-CRP in two groups were significantly decreased (P < 0.05), and more significantly in the treatment group (P < 0.05). Conclusion Guanxin Shutong Capsules combined with recombinant human brain natriuretic peptide has exact effect in treatment of chronic heart failure with good safety, and can effectively improve the heart function of patients, promote the recovery of life ability and exercise endurance, which can reduce the inflammatory injury and myocardial damage.

R972

渭南市科技計(jì)劃項(xiàng)目（2022ZDYFJH-54）