【摘要】 目的探究参芪扶正注射液联合美托洛尔对心肌梗死经皮冠脉内介入治疗(PCI)术后心力衰竭患者的疗效。方法回顾性分析2017年7月至2019年12月安徽医科大学附属宿州医院收治的心肌梗死PCI术后心力衰竭患者88例。采用随机数字表法分为观察组(n=46)和对照组(n=42)。对照组给予美托洛尔治疗,观察组在对照组基础上加用参芪扶正注射液治疗,疗程3个月。分析2组患者治疗3个月后临床疗效,治疗前及治疗3个月后心率、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)水平,血浆血管紧张素Ⅱ、内皮素、B型脑钠肽水平以及不良反应发生情况。结果观察组治疗总有效率为89.13%,高于对照组的71.43%,差异有统计学意义(P <0.05)。治疗前,2组患者心率、LVEF、LVEDd水平比较,差异均无统计学意义(P> 0.05);治疗3个月后,观察组患者心率、LVEDd为(76.53±6.62)次/min、(46.22±4.18) mm,低于对照组[(88.71±7.43)次/min、(50.23±4.43) mm],LVEF为(42.40±7.11)%,高于对照组[(36.82±6.21)%],差异均有统计学意义(P <0.05)。治疗前,2组患者血浆血管紧张素Ⅱ、内皮素、脑钠素水平比较,差异均无统计学意义(P> 0.05);治疗3个月后,观察组患者血浆血管紧张素Ⅱ、内皮素、脑钠素水平分别为(135.52±24.58) pg/mL、(53.78±22.92) ng/L、(288.06±65.12)μg/L,均低于对照组[(161.43±23.76) pg/m L、(84.78±27.58) ng/L、(372.12±64.96)μg/L],差异均有统计学意义(P <0.05)。观察组患者总不良反应发生率为13.04%,与对照组的9.52%比较,差异无统计学意义(P> 0.05)。结论参芪扶正注射液联合美托洛尔治疗心肌梗死PCI术后心力衰竭患者疗效优于单纯美托洛尔治疗,能够较好改善患者心率、LVEF、LVEDd水平,恢复心功能,且未新增不良反应。更多还原

【Abstract】 Objective To explore the effect of Shenqi Fuzheng Injection combined with metoprolol in myocardial infarction with heart failure after percutaneous coronary intervention( PCI). Methods A total of 88 patients with heart failure after PCI treated in Suzhou Hospital Affiliated to Anhui Medical University from July 2017 to December 2019 were retrospectively analyzed and randomly divide into observation group( n =46) and control group( n = 42). The control group was treated with metoprolol,and the observation group was treated with Shenqi Fuzheng Injection on the basis of the control group. The clinical efficacy for 3 months of treatment,heart rate,left ventricular ejection fraction( LVEF),and left ventricular end diastolic diameter( LVEDd) levels,plasma angiotensin II( Ang II),endothelin( ET) and B-type brain natriuretic peptide( BNP) levels before and 3 months after treatment,and adverse reactions were analyzed. Results The total effective rate of treatment in the observation group was 89. 13%,which was higher than 71. 43% in the control group,and the difference was statistically significant( P < 0. 05). Before treatment,there were no statistically significant difference in heart rate,LVEF,and LVEDd levels between the two groups of patients( P >0. 05); after 3 months of treatment,the observation group’s heart rate and LVEDd were( 76. 53 ± 6. 62) times/min,( 46. 22 ± 4. 18) mm,which were lower than those in the control group [( 88. 71 ± 7. 43) times/min,( 50. 23 ± 4. 43) mm],LVEF was( 42. 40 ± 7. 11) %,which was higher than that in the control group [( 36. 82 ± 6. 21) % ],the differences were statistically significant( P < 0. 05). Before treatment,there was no statistically significant difference in plasma angiotensin Ⅱ,endothelin,and brain natriuretic peptide levels between the two groups( P > 0. 05);after 3 months of treatment,the levels of plasma angiotensin Ⅱ,endothelin,brain natriuretic peptide in the observation group were( 135. 52 ±24. 58) pg/mL,( 53. 78 ± 22. 92) ng/L,( 288. 06 ± 65. 12) μg/L,which were lower than those in the control group [( 161. 43 ± 23. 76) pg/m L,( 84. 78 ± 27. 58) ng/L,( 372. 12 ± 64. 96) μg/L],the differences were statistically significant( P < 0. 05). The total adverse reaction rate in the observation group was 13. 04%,which was not statistically significant compared with 9. 52% in the control group( P > 0. 05). Conclusion Shenqi Fuzheng Injection combined with metoprolol has better efficacy in myocardial infarction with heart failure after PCI than metoprolol alone,which can better improve the levels of HR,LVEF,and LVEDd,and restore cardiac function without new adverse reactions.更多还原