生脉注射液对扩张型心肌病患者血流动力学的影响

作者	单位
张亚臣	上海第二医科大学附属新华医院心内科
陈瑞明	上海第二医科大学附属瑞金医院检验科
赵美华	上海第二医科大学附属新华医院心内科
吕宝经	上海第二医科大学附属新华医院心内科
荣烨之	上海第二医科大学附属新华医院心内科

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中文摘要:

目的 :观察生脉注射液对扩张型心肌病患者血流动力学的影响 ,探讨生脉注射液对扩张型心肌病心功能不全患者的临床疗效。方法 :将 10 0例扩张型心肌病心功能不全患者分为两组 :治疗组 5 0例 ,其中心功能Ⅱ级 10例 ,Ⅲ级 35例 ,Ⅳ级 5例。对照组 5 0例 ,其中心功能Ⅱ级 10例 ,Ⅲ级 36例 ,Ⅳ级 4例。治疗组在对照组常规治疗基础上加用生脉注射液 ,并于治疗前后观察两组心功能改善情况 ,同时测定血液动力学指标。结果 :治疗组显效 2 2例 ,有效 2 0例 ,有效率 84 % ;对照组显效 14例 ,有效 16例 ,有效率 6 0 %。两组比较差异有显著性 (χ2 =7 14 ,P <0 0 1) ,治疗后治疗组心输出量 (CO)、心搏出量 (SV)、心脏指数 (CI)、射血分数 (EF)、左室短轴缩短率 (△D % )、室壁增厚率 (△T % )均显著增加 ,体循环外周阻力 (SVR)则明显降低 ,治疗前后比较 ,差异均有显著性 (P <0 0 5 ) ;对照组上述各指标均无明显变化 (均P >0 0 5 )。治疗后治疗组EF、SV较对照组明显增加 ,SVR明显降低 ,两组比较 ,差异有显著性 (P <0 0 5 )。结论 :生脉注射液能明显改善扩张型心肌病的心功能 ,与西药合用能取得更好的治疗效果。

英文摘要:

Objective: To observe the effects of Shengmai Injection (SMI) on hemodynamics in patients with dilated cardiomyopathy (DCM), and to explore the clinical effect of SMI in treating patients of DCM with heart failure. Methods: One hundred patients were divided into two groups. In the 50 cases of the treated group, 10 cases with heart function of Ⅱ degree, 35 of Ⅲ degree and 5 of Ⅳ degree. The corresponding number of cases in the 50 patients of the control group were 10, 36 and 4. Conventional treatment was given to both groups, and SMI was administered to the treated group additionally. The therapeutic effect and the indexes of heart function before and after treatment were determined and compared. Results: In the treated group, treatment showed markedly effective in 22 cases and effective in 20, the total effective rate being 84%, while in the control group, markedly effective in 14 and effective in 16, the total effective rate being 60%, the comparison between the two groups showed significant difference (χ 2=7 14,P<0 01). In the treated group, cardiac output, stroke volume (SV), cardiac index, eject fraction (EF), lefe ventricular minor axis shortened rate, ventricular wall thickened rate were all increased after treatment and system vascular resistance (SVR) decreased significantly (P<0 05), while in the control group, insignificant change was found in the above mentioned parameters after treatment (P>0 05). Comparison between the two groups after treatment showed that EF and SV were obviously higher and SVR obviously lower in the treated group than those in the control group. Conclusion: SMI could markedly improve the heart function of patients with DCM. The effect of conventional treatment would be enhanced in combination therapy with SMI.

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