本文選題：慢性心力衰竭 + 心脈隆注射液��； 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]通過觀察心脈隆注射液配合常規(guī)藥物治療慢性心力衰竭患者的療效和預后相關指標以及與目前常規(guī)藥物抗心衰治療對比有無優(yōu)勢,初步探討心脈隆注射液臨床推廣應用價值。[方法]將2016年3月到2016年11月在昆明醫(yī)科大學第二附屬醫(yī)院心內科三病區(qū)入院的符合入組條件的慢性心衰患者42例,按隨機數表法隨機分成常規(guī)治療組及心脈隆治療組各21例。兩組患者均給予規(guī)范化常規(guī)藥物抗心衰治療,心脈隆治療組則為常規(guī)藥物輔以心脈隆注射液治療,分別在治療前及治療5天后、1個月、3個月觀察隨訪各組的左室射血分數、N-端腦利鈉肽前體、6分鐘步行距離、NYHA心功能分級指標;觀察患者住院期間有無藥物不良反應;分別于治療前、隨訪1個月、隨訪3個月時對各組患者進行明尼蘇達生活質量量表評分;對各組患者均進行3個月的隨訪,觀察患者主要不良心血管事件發(fā)生情況,結果進行統(tǒng)計學分析。[結果]1、兩組間年齡(t=0.145,P=0.885)、病程(t=0.990,P=0.328)、性別(χ2=0.099,P=0.753)、基礎心臟疾病(χ2=0.492,P=0.847)、病情(χ2=0.110,P=0.946)比較無統(tǒng)計學差異(P0.05),兩組均衡可比。2、兩組左室射血分數(LVEF)比較:兩組治療前LVEF無統(tǒng)計學差異,治療后、隨訪1月后、隨訪3月后較治療前均升高(P0.05),且心脈隆治療組LVEF高于常規(guī)治療組(P0.05)。3、兩組N-端腦利鈉肽前體(NT-proBNP)比較:兩組治療前NT-proBNP無統(tǒng)計學差異,治療后、隨訪1月后、隨訪3月后較治療前均降低(P0.05),且心脈隆治療組降低更明顯(P0.05)。4、兩組6分鐘步行距離(6MWD)比較:兩組治療前6MWD無統(tǒng)計學差異,治療后、隨訪1月后、隨訪3月后較治療前均升高(P0.05),且心脈隆治療組6MWD高于常規(guī)治療組(P0.05)。5、兩組NYHA心功能分級改善情況的比較:心脈隆治療組NYHA心功能分級顯效率(61.90%)高于常規(guī)治療組(19.05%),有統(tǒng)計學差異(χ2=8.005,P=0.005)。6、兩組肝腎功能、血小板、血紅蛋白指標的觀察:兩組患者用藥后,心脈隆治療組有1例患者出現血小板減少的情況,余患者未出現明顯藥物不良反應,兩組患者肝功能、血小板、血紅蛋白指標治療前后無統(tǒng)計學差異(P0.05),兩組患者肌酐治療前無統(tǒng)計學差異,治療后肌酐較治療前均下降(P0.001),且心脈隆治療組降低更明顯(P0.05)。7、兩組明尼蘇達生活質量量表(MLHFQ)評分的比較:兩組治療前MLHFQ評分無統(tǒng)計學差異,隨訪1月后、隨訪3月后較治療前均降低(P0.05),且心脈隆治療組MLHFQ評分低于常規(guī)治療組(P0.05)。8、兩組治療后1個月、3個月主要不良心血管事件(MACE)發(fā)生率比較:隨訪3個月時心脈隆治療組主要不良心血管事件發(fā)生率(14.29%)低于常規(guī)治療組(42.86%),有統(tǒng)計學差異(χ2=4.200;P=0.04)。[結論]1、心脈隆注射液對慢性心力衰竭患者有一定的療效,且配合現指南推薦的治療方案有協同作用;2、心脈隆注射液可能改善慢性心力衰竭患者的生活質量及近期預后。
[Abstract]:[objective] to observe the efficacy and prognostic indexes of Xinmailong injection combined with conventional drugs in the treatment of chronic heart failure and whether there are advantages compared with the current anti-heart failure therapy. To explore the clinical application value of Xinmailong injection. [methods] from March 2016 to November 2016, 42 patients with chronic heart failure (CHF) who were admitted to the third ward of Department of Cardiology, second affiliated Hospital of Kunming Medical University, were enrolled in the study. According to the method of random number, the patients were randomly divided into two groups: routine treatment group (21 cases) and cardiolon treatment group (21 cases). The patients in both groups were treated with standardized routine drugs for anti-heart failure, while those in the group treated with Xinmailong injection were treated with routine drugs. Left ventricular ejection fraction (LVEF) and 6-minute walking distance of NCNP precursor were observed before treatment and 5 days, 1 month and 3 months after treatment respectively. The patients in each group were evaluated with Minnesota quality of Life scale before treatment, 1 month after treatment, 3 months after follow-up, and 3 months after follow-up to observe the occurrence of major adverse cardiovascular events in each group. Results Statistical analysis was carried out. [results] 1. There was no significant difference in age between the two groups (蠂 2 / 0. 492P 0. 847, P 0. 010 P 0. 946), and the comparison of left ventricular ejection fraction (LVEF) between the two groups. There was no significant difference in LVEF between the two groups (蠂 2 0. 099 P 0. 946). There was no significant difference between the two groups in left ventricular ejection fraction (LVEF) before treatment. After treatment, there was no significant difference between the two groups in terms of left ventricular ejection fraction (LVEF). After 1 month follow-up, there was no statistical difference between the two groups (蠂 2: 0. 10, P 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P < 0. 05). After 3 months of follow-up, the levels of P0.05 and LVEF in the cardiolon treatment group were higher than those in the routine treatment group. The comparison of NT-proBNPs between the two groups: there was no significant difference in NT-proBNP between the two groups before and after treatment, and after one month follow-up, there was no significant difference between the two groups. After 3 months of follow-up, the levels of P0.05D were lower than those before treatment, and the decrease was more obvious in the cardiolon group. The 6-minute walking distance of the two groups was 6MWD. There was no significant difference in 6MWD between the two groups before and after treatment, and after one month follow-up, there was no significant difference between the two groups. After 3 months of follow-up, the levels of P0.05 and 6MWD in the cardiolon treatment group were higher than those in the routine treatment group. The improvement of cardiac function in the two groups was higher than that in the routine treatment group. The difference between the two groups was as follows: the markedly effective rate of NYHA cardiac function grading in the cardiolon treatment group was 61.90) higher than that in the routine treatment group (19.05%). The difference was statistically significant (蠂 ~ 2 / 8.005 P ~ (0.005) P ~ (0.005) 路6). The liver and kidney function of the two groups were as follows: Observation of platelet and hemoglobin index: after two groups of patients were treated, one patient in the treatment group had thrombocytopenia, the remaining patients had no obvious adverse drug reaction, the two groups had liver function, platelet, There was no statistical difference in hemoglobin index before and after treatment (P 0.05), but there was no statistical difference between the two groups before and after treatment with creatinine. After treatment, the creatinine level decreased significantly (P 0.001), and the cardiac myelong group decreased more significantly (P 0.05). The comparison of the Minnesota quality of Life scale (MQL) score between the two groups: there was no significant difference between the two groups before treatment and 1 month after follow-up, and there was no significant difference between the two groups in the score of MLHFQ before treatment, and there was no significant difference between the two groups after one month of follow-up. After 3 months follow-up, all the patients were lower than before treatment, and the MLHFQ score of the cardiolon treatment group was lower than that of the routine treatment group. The incidence of major adverse cardiovascular events in the two groups was 1 month and 3 months after treatment: at the end of 3 months follow-up, the incidence rate of major adverse cardiovascular events was higher in the cardiolabar treatment group than that in the routine treatment group. The incidence of major adverse cardiovascular events (14.29%) was significantly lower than that in the routine treatment group (42.86%) (蠂 ~ 2 = 4.200). [conclusion] 1. Xinmailong injection has a certain curative effect on patients with chronic heart failure, and has synergistic effect in combination with the current guidelines. Xinmailong injection may improve the quality of life and short-term prognosis of patients with chronic heart failure.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.6

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