摘要
目的 探讨芪苈强心胶囊联合尼可地尔在急诊经皮冠状动脉介入治疗(PCI)术后射血分数保留的心力衰竭(HFpEF)患者中的应用效果。方法 选取2019年2月至2021年12月宝鸡市人民医院诊治的100例急诊PCI术后HFpEF患者为研究对象,按随机单双数法将其分为对照组(常规治疗基础上予以尼可地尔治疗)和研究组(常规治疗基础上予以芪苈强心胶囊联合尼可地尔治疗)各50例。治疗12周后,比较两组患者治疗前后的超声心功能指标[包括左心室射血分数(LVEF)、左心室收缩末内径(LVESD)、左心室舒张末内径(LVEDD)、舒张早期二尖瓣血流速度(E)/舒张晚期二尖瓣血流速度(A)]、生活质量及血清超敏C反应蛋白(hs-CRP)和N末端B型脑钠肽前体(NT-proBNP)水平;随访6个月,比较两组患者的主要心血管不良事件(MACE)发生情况。结果 治疗12周后,两组患者的LVEF、E/A均明显提高,LVESD、LVEDD均明显降低,且研究组患者的LVEF、E/A分别为(57.91±6.33)%、1.24±0.25,明显高于对照组的(55.12±6.08)%、1.01±0.22,LVESD、LVEDD分别为(41.09±4.33) mm、(44.97±4.64) mm,明显低于对照组的(50.04±5.27) mm、(50.83±5.36) mm,差异均有统计学意义(P<0.05);治疗12周后,两组的明尼苏达心功能不全生命质量量表(MLHFQ)各维度及综合评分均明显提高,且研究组的MLHFQ各维度及综合评分分别为(22.72±5.35)分、(33.45±4.31)分、(35.92±2.11)分、(93.21±10.33)分,均明显高于对照组的(19.83±4.16)分、(24.36±6.02)分、(27.06±7.02)分、(75.12±13.08)分,差异均有统计学意义(P<0.05);治疗12周后,两组患者的血清hs-CRP、NT-proBNP水平均明显降低,且研究组患者的血清hs-CRP、NT-proBNP水平分别为(328.23±81.16) mg/L、(2.82±0.35) ng/L,明显低于对照组的(497.22±95.56) mg/L、(4.34±0.97) ng/L,差异均有统计学意义(P<0.05);随访6个月,研究组患者的MACE发生率为4.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论 芪苈强心胶囊联合尼可地尔在急诊PCI术后HFpEF患者中的应用能明显改善患者的心功能,提高生活质量,降低血清hs-CRP、NT-proBNP水平,进一步减少MACE的发生,临床应用效果显著。
Objective To investigate the application effect of Qili Qiangxin capsule combined with nicorandil in patients with heart failure with preserved ejection fraction(HFpEF)after emergency percutaneous coronary interven-tion(PCI).Methods A total of 100 patients with HFpEF after emergency PCI in Baoji People's Hospital from February 2019 to December 2021 were selected as the study objects.According to the random single and even number method,they were divided into a control group(50 cases,treated with nicorandil on the basis of conventional treatment)and a study group(50 cases,treated with Qili Qiangxin capsule combined with nicorandil on the basis of conventional treat-ment).After 12 weeks of treatment,the echocardiographic function indicators[including left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),and early dia-stolic mitral valve blood flow velocity(E)/late diastolic mitral valve blood flow velocity(A)],quality of life and serum levels of high-sensitivity C-reactive protein(hs-CRP),and N-terminal precursor B-type natriuretic peptide(NT-proBNP)of the two groups before and after treatment were compared.After 6 months of follow-up,the incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results After 12 weeks of treatment,the LVEF and E/A of the two groups were significantly increased,the LVESD and LVEDD were significantly decreased;the LVEF and E/A of the study group were(57.91±6.33)%,1.24±0.25,respectively,which were significantly higher than(55.12±6.08)%,1.01±0.22 of the control group,and LVESD and LVEDD were(41.09±4.33)mm,(44.97±4.64)mm,which were significantly lower than(50.04±5.27)mm,(50.83±5.36)mm of the control group,with statistically signifi-cant differences(P<0.05).After 12 weeks of treatment,the dimensions and comprehensive scores of Minnesota Cardiac Insufficiency Quality of Life Scale(MLHFQ)in the two groups were significantly improved,and the dimensions and comprehensive scores of MLHFQ in the study group were(22.72±5.35)points,(33.45±4.31)points,(35.92±2.11)points,(93.21±10.33)points,respectively,which were significantly higher than(19.83±4.16)points,(24.36±6.02)points,(27.06±7.02)points,(75.12±13.08)points of the control group(P<0.05).After 12 weeks of treatment,the levels of se-rum hs-CRP and NT-probNP in the two groups were significantly decreased,and the serum levels of hs-CRP and NT-proBNP in the study group were(328.23±81.16)mg/L,(2.82±0.35)ng/L,respectively,which were significantly low-er than(497.22±95.56)mg/L,(4.34±0.97)ng/L in the control group(P<0.05).After 6 months of follow-up,the inci-dence of MACE in the study group was 4.00%,which was significantly lower than 18.00%in the control group(P<0.05).Conclusion Qili Qiangxin capsule combined with nicorandil for HFpEF patients after emergency PCI can signif-icantly improve cardiac function,improve quality of life,reduce the serum levels of hs-CRP and NT-probNP,and further reduce the occurrence of MACE,with significant clinical effect.
作者
吴丹
曲萌
苏垠旭
罗春艳
WU Dan;QU Meng;SU Yin-xu;LUO Chun-yan(Department of Traditional Chinese Medicine,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第10期1374-1378,共5页
Hainan Medical Journal
基金
陕西省自然科学基金(编号:2017SF128)。
关键词
射血分数保留的心力衰竭
经皮冠状动脉介入治疗
芪苈强心胶囊
尼可地尔
心功能
生活质量
Heart failure with preserved ejection fraction(HFpEF)
Percutaneous coronary intervention
Qili Qiangxin capsule
Nicorandil
Cardiac function
Quality of life
