2020 年第 10 期 第 15 卷

参麦注射液对急性心力衰竭伴肾功能不全患者心肾功能和心肌细胞凋亡因子水平的影响

Effect of Shenmai injection on cardiorenal function and myocardial apoptotic factor level in patients with acute heart failure and renal insufficiency

作者：黎简平1傅永平2易昌容2

英文作者：Li Jianping1 Fu Yongping2 Yi Changrong2

单位：1绍兴文理学院附属医院绍兴市立医院急诊内科312000；2绍兴文理学院附属医院绍兴市立医院心内科312000

英文单位：1Department of Emergency Internal Medicine Affiliated Hospital of Shaoxing University Shaoxing Municipal Hospital Zhejiang Province Shaoxing 312000 China; 2Department of Cardiology Affiliated Hospital of Shaoxing University Shaoxing Municipal Hospital Zhejiang Province Shaoxing 312000 China

关键词：急性心力衰竭；肾功能不全；心肾功能；参麦注射液；细胞凋亡因子

英文关键词：Acuteheartfailure;Renalinsufficiency;Cardiorenalfunction;Shenmaiinjection;Apoptoticfactor

• 摘要：

• 目的 探讨参麦注射液对急性心力衰竭伴肾功能不全患者心肾功能和心肌细胞凋亡因子水平的影响。方法 选取绍兴文理学院附属医院2016年7月至2018年12月收治的100例急性心力衰竭伴肾功能不全患者作为研究对象，根据随机数字表法分为对照组（50例）和观察组（50例），对照组采用常规治疗，观察组在常规治疗基础上加用参麦注射液治疗。比较2组临床疗效、治疗前后心肾功能指标、N末端B型脑钠肽前体及心肌细胞凋亡因子水平和不良反应发生率。结果 观察组治疗总有效率明显高于对照组［88.0%(44/50)比76.0%(38/50)］（P＜0.05）。治疗后，2组左心室射血分数及每搏输出量均明显高于治疗前，且观察组高于对照组，2组左心室舒张末期内径、左心室收缩末期内径、N末端B型脑钠肽前体、血尿素氮、血肌酐、可溶性凋亡因子、可溶性凋亡因子配体、肿瘤坏死因子α水平均低于治疗前，且观察组低于对照组（均P＜0.05）。观察组不良反应发生率明显低于对照组［10.0%（5/50）比22.0%（11/50）］（P＜0.05）。结论 常规治疗基础上加用参麦注射液治疗急性心力衰竭伴肾功能不全能够明显提高患者临床疗效，改善其心肾功能，降低心肌细胞凋亡因子水平。

• Objective To investigate the effects of Shenmai injection on cardiorenal function and cardiac apoptotic factor levels in patients with acute heart failure and renal insufficiency. Methods From July 2016 to December 2018, 100 patients with acute heart failure and renal insufficiency admitted to the Affiliated Hospital of Shaoxing University were selected. According to the random number table method, they were divided into control group (50 cases) and observation group (50 cases). The control group was treated with routine treatment, and the observation group was treated with Shenmai injection on the basis of routine treatment. The clinical effect, cardiac and renal function indexes, N-terminal B-type brain natriuretic peptide precursor, apoptotic factor level of myocardial cells and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The total effective rate in observation group was significantly higher than that in control group［88.0%(44/50) vs 76.0%(38/50)，P＜0.05］. After treatment, the left ventricular ejection fraction and stroke output of both groups were significantly higher than those before treatment; the levels in observation group were higher than those in control group, the left ventricular end diastolic diameter, left ventricular end systolic diameter, N-terminal B-type brain natriuretic peptide precursor, blood urea nitrogen, blood creatinine, soluble apoptotic factor, soluble apoptotic factor ligand, tumor necrosis factor-α levels in both groups were lower than those before treatment; the levels in observation group were lower than those in control group (all P＜0.05). The incidence of adverse reactions in observation group was significantly lower than that in control group［10.0%（5/50） vs 22.0%（11/50），P＜0.05］. Conclusion On the basis of routine treatment, Shenmai injection can significantly improve the clinical therapeutic effect, improve the cardiorenal function and reduce the level of apoptotic factors of cardiac myocytes in patients with acute heart failure and renal insufficiency.