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目的:对扩张型心肌病、缺血性心肌病、瓣膜病心力衰竭采用心区交感神经阻滞治疗,探讨该方法对不同病因心衰的作用。方法:对48例扩心病(A组=16例)、缺血性心肌病(B组=16例)、瓣膜病(C组-16例)心衰患者进行心区交感神经阻滞治疗28天,治疗前和治疗后4周利用彩超采集心功能(左室射血分数)、左室舒张末期内径及检测血浆NT-proBNP水平。结果:A、B、C三组治疗后中,C组各指标较A、B两组明显改善,A组较B组各指标也有显著差异,P<0.01。左室射血分数(LVEF)明显增加(P<0.01),左室舒张末期内径(LVEDD)明显缩小(P<0.01),N-端脑利钠肽前体(NT-proBNP)水平明显下降(P<0.01)。C组总有效率为100%,明显高于A(93.75%)、B(81.25%)两组,同时A、B两组间差异存在显著性。结论:心区交感神经阻滞对严重心衰患者治疗有着卓越的帮助。心区交感神经阻滞治疗瓣膜病心衰效果最好、其次为扩心病;对于缺血性心肌病虽然有效,但效果次于前两种疾病。
OBJECTIVE: To study the effect of this method on heart failure with different etiologies by dilated cardiomyopathy, ischemic cardiomyopathy and valvular heart failure. Methods: Cardiac sympathetic nerve block was treated for 28 days in 48 patients with heart disease (group A = 16), ischemic cardiomyopathy (group B = 16) and valvular disease (group C - 16) , Before treatment and 4 weeks after treatment, the cardiac function (left ventricular ejection fraction), left ventricular end-diastolic diameter and plasma NT-proBNP level were collected by color Doppler ultrasound. Results: After treatment, the indexes in group C were significantly improved compared with those in groups A and B, and there were significant differences in each index between group A and group B (P <0.01). The left ventricular ejection fraction (LVEF) increased significantly (P <0.01), the left ventricular end diastolic diameter (LVEDD) decreased significantly (P <0.01) and N-terminal brain natriuretic peptide precursor (NT-proBNP) P <0.01). The total effective rate in group C was 100%, which was significantly higher than that in group A (93.75%) and group B (81.25%). There was also significant difference between groups A and B. CONCLUSIONS: Cardiac sympathetic blockade is of great help in the treatment of patients with severe heart failure. Cardiac sympathetic nerve block treatment of valvular heart failure best, followed by heart disease; effective for ischemic cardiomyopathy, but the effect is inferior to the first two diseases.