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目的探讨人参果总皂苷联合二丁酰环磷腺苷钙治疗慢性心力衰竭合并缓慢型心律失常的疗效。方法慢性心力衰竭患者240例,随机分为对照组、治疗组1、治疗组2,对照组给予改善循环、利尿、扩管等常规纠正心衰治疗。治疗组1在对照组治疗基础上加用人参果总皂苷口服4 w及二丁酰环磷腺苷钙静点2 w,治疗组2在对照组治疗基础上加用人参果总皂苷口服8 w及二丁酰环磷腺苷钙静点2 w,分别观察治疗前、治疗4、8 w时的患者6 min步行距离、24 h平均心室率、左室射血分数(LVEF)、血浆脑钠肽(BNP)、血清内皮素(ET)-1、基质金属蛋白酶(MMP)-9水平。结果治疗组1和治疗组2与对照组比较,治疗4、8 w的6 min步行距离、LVEF比较差异有统计学意义(P<0.05),ET-1、MMP-9及BNP水平显著降低(P<0.05)。治疗2组与治疗组1比较,治疗前、治疗4 w上述指标差异无统计学意义(P>0.05),治疗组2治疗8 w较治疗组1 LVEF、6 min步行试验显著提高,EF-1、MMP-9、BNP水平显著降低,差异有统计学意义(P<0.05)。结论人参果总皂苷联合二丁酰环磷腺苷钙可明显改善慢性心力衰竭合并缓慢型心律失常患者的心功能,抑制细胞凋亡,减缓心室重构,提高运动耐量,改善生活质量。
Objective To investigate the curative effect of ginseng fruit total saponin combined with calcium dibutyryl cyclic adenosine monophosphate on chronic heart failure complicated with arrhythmia. Methods 240 patients with chronic heart failure were randomly divided into control group, treatment group 1, treatment group 2, and control group were given routine treatment to correct heart failure such as circulation, diuretic, and expansion. Treatment group 1 in the control group plus ginseng total saponin oral administration of 4 w and intravenous infusion of dibutyryl cyclic adenosine monophosphate 2 w, the treatment group 2 in the control group based on the application of ginseng fruit saponins oral 8 w and dibutyrylcyanide Adenosine calcium was intravenously injected for 2 weeks to observe the walking distance, mean ventricular rate at 24 hours, left ventricular ejection fraction (LVEF), plasma brain natriuretic peptide (BNP), serum Endothelin (ET) -1, matrix metalloproteinase (MMP) -9 levels. Results Compared with the control group, the LVEF in treatment group 1 and treatment group 2 were significantly different (P <0.05), the levels of ET-1, MMP-9 and BNP were significantly decreased P <0.05). Compared with treatment group 1, there was no significant difference between the two groups before treatment and the treatment group for 4 weeks (P> 0.05). The treatment group 2 treatment 8 w was significantly higher than the treatment group 1-LVEF 6-min walk test, EF-1 , MMP-9, BNP levels were significantly lower, the difference was statistically significant (P <0.05). Conclusion Ginsenosides plus biliary adenosine monophosphate can significantly improve cardiac function, inhibit apoptosis, alleviate ventricular remodeling, improve exercise tolerance and improve quality of life in patients with chronic heart failure complicated with arrhythmia.