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目的:观察参麦注射液联合美托洛尔对充血性心力衰竭(CHF)患者的疗效及血浆脑钠肽(BNP)、细胞反应蛋白(CRP)的影响。方法:90例CHF患者,随机分为分为联合组(美托洛尔加参麦注射液)32例,美托若尔组30例,正常对照组28例。常规治疗组使用强心剂、ACEI、利尿剂及血管扩张剂,并酌情予吸氧、抗感染,降压等对症处理;美托若尔组在常规治疗药物的基础上加用美托洛尔,联合组则加用美托洛尔和参麦注射液,治疗12周后,观察治疗效果并测定治疗前后左心室射血分数(LVFF)、左心室舒张末期内径(LVEDd)、血浆BNP和CRP水平。结果:治疗8周后联合组总有效率高于对照组(P<0.05),高于对照组(P<0.05)。与对照组相比,联合组LVEF、LVEDd、BNP和CRP差异有统计学意义(P<0.05);与美托洛尔组相比,联合组BNP和CRP差异亦有统计学意义。结论:参麦注射液联合美托洛尔能明显改善CHF患者的心功能,降低异常升高的BNP和CRP水平,逆转心室重塑。
Objective: To observe the therapeutic effect of Shenmai injection combined with metoprolol on patients with congestive heart failure (CHF) and the effects of plasma BNP and CRP. Methods: Ninety CHF patients were randomly divided into three groups: metoprolol plus Shenmai injection, 30 cases of Metoluoer group and 28 cases of normal control group. The conventional treatment group used tonicity, ACEI, diuretic and vasodilator, and symptomatic treatment such as oxygen absorption, anti-infective and antihypertensive treatment were given as appropriate. Metoprolol group was treated with metoprolol on the basis of conventional treatment, Group was treated with metoprolol and Shenmai injection. After 12 weeks of treatment, the therapeutic effect was observed and the left ventricular ejection fraction (LVFF), left ventricular end diastolic dimension (LVEDd), plasma BNP and CRP levels were measured before and after treatment. Results: The total effective rate of the combined group after 8 weeks of treatment was higher than that of the control group (P <0.05), higher than that of the control group (P <0.05). Compared with the control group, the differences of LVEF, LVEDd, BNP and CRP in the combined group were statistically significant (P <0.05). Compared with the metoprolol group, the differences of BNP and CRP in the combined group were also statistically significant. Conclusion: Shenmai injection combined with metoprolol can significantly improve cardiac function, reduce abnormally elevated BNP and CRP levels and reverse ventricular remodeling in CHF patients.