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目的观察麝香保心丸对维持性血液透析伴慢性心力衰竭(心衰)患者血BNP的影响。方法选择2013年7月—2014年12月收治的慢性肾功能衰竭(肾衰)伴慢性心衰患者60例作为研究对象,随机分为对照组和观察组各30例。对照组给予维持性血液透析及口服药物治疗;观察组在对照组基础上给予麝香保心丸3~6丸/次,3次/d治疗,两组均治疗3个月。观察患者血BNP、心脏彩超及6分钟步行试验的变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,等级资料采用Fisher确切概率法,P<0.05为差异有统计学意义。结果观察组治疗后BNP、左室射血分数(left ventricular ejection fractions,LVEF)、A峰E峰流速比值(E/A)及6分钟步行试验结果分别为(308.9±30.4)pg/ml、(48.6±1.03)%、(1.13±0.17)、(405.9±40.1)m,均明显优于治疗前的(1 107.0±25.6)pg/ml、(30.1±1.07)%、(0.59±0.10)、(303.1±35.8)m,差异均有统计学意义(均P<0.05)。治疗后,观察组BNP、LVEF、E/A及6分钟步行试验均明显优于对照组[(1 102.5±30.5)pg/ml、(29.8±1.56)%、(0.69±0.11)、(305.9±40.5)m],差异均有统计学意义(均P<0.05)。结论麝香保心丸能降低慢性肾衰维持性血液透析伴慢性心衰患者的血BNP水平,进而改善心脏功能,具有心脏保护作用,值得临床推广应用及进一步研究。
Objective To observe the effect of Shexiang Baoxin Pill on blood BNP in maintenance hemodialysis patients with chronic heart failure (HF). Methods Sixty patients with chronic renal failure and chronic heart failure who were admitted to our hospital from July 2013 to December 2014 were randomly divided into control group and observation group of 30 cases. The control group was given maintenance hemodialysis and oral drug treatment. The observation group was treated with 3 ~ 6 pills of musk heart Pill, 3 times / d on the basis of the control group. Both groups were treated for 3 months. The change of blood BNP, CHD and 6-minute walking test were observed. The t test was used to compare the measurement data between the two groups. Paired t-test was used to compare the data of the measurement group and the Fisher’s exact test was applied to the grade data. P <0.05 was considered statistically significant. Results The BNP, LVEF, E / A and 6-minute walk test in the observation group were (308.9 ± 30.4) pg / ml and 48.1 ± 1.03%, 1.13 ± 0.17, and (405.9 ± 40.1) m, respectively, were significantly better than those before treatment (107.0 ± 25.6) pg / ml, 303.1 ± 35.8) m, the differences were statistically significant (all P <0.05). After treatment, BNP, LVEF, E / A and 6-minute walk test in the observation group were significantly better than those in the control group [(1 102.5 ± 30.5) pg / ml, (29.8 ± 1.56)%, (0.69 ± 0.11), (305.9 ± 40.5) m], the differences were statistically significant (all P <0.05). Conclusion Shexiang Baoxin Pill can reduce the blood BNP level in patients with chronic renal failure with hemodialysis and chronic heart failure, improve cardiac function and have cardioprotection. It is worthy of clinical application and further study.