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目的观察参麦注射液对慢性充血性心力衰竭的疗效及对超声心动图指标、血浆脑钠肽(BNP)及金属蛋白酶(MMP9)的影响。方法将患者随机分为两组,对照组予血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)、利尿剂(呋塞米、螺内酯)、β受体阻滞剂、洋地黄、必要时硝酸盐类等,治疗组在上述西药基础上加用中药参麦注射液;疗程均为1周。通过心脏彩超检测左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF),BNP、MMP9并测定6 min步行距离(6-MWT)。结果与对照组比较,治疗组LVEF升高及6-MWT增加程度更明显,BNP及MMP9下降程度亦更明显。结论在西医常规治疗基础上加用参麦注射液治疗慢性充血性心力衰竭效果显著,可更有效地降低血浆中BNP水平,降低血清MMP9浓度,增加LVEF、6-MWT。
Objective To observe the therapeutic effect of Shenmai injection on chronic congestive heart failure and its effects on echocardiographic parameters, plasma brain natriuretic peptide (BNP) and metalloproteinase (MMP9). Methods The patients were randomly divided into two groups: the control group received angiotensin converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor antagonist (ARB), diuretic (furosemide, spironolactone), β block Agent, digitalis, nitrate if necessary, the treatment group on the basis of the above western medicine plus traditional Chinese medicine Shenmai injection; treatment for 1 week. Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), BNP and MMP-9 were measured by echocardiography and 6 min walking distance (6-MWT) was measured. Results Compared with the control group, the LVEF and 6-MWT increased more significantly in the treatment group, and the decreased levels of BNP and MMP9 were more obvious. Conclusion The addition of Shenmai injection in the treatment of chronic congestive heart failure on the basis of routine treatment of Western medicine has a significant effect, which can effectively lower plasma BNP level, lower serum MMP9 concentration and increase LVEF and 6-MWT.