心脉隆治疗冠脉三支病变合并心衰的临床研究梁田张庆(江苏省徐州市中医院心内科江苏徐州221003)【摘要】目的：探讨心脉隆注射液治疗冠脉三支病变合并心袞(CHF)患者的疗效及安全性。方法：将冠脉造影三支病变合并心衰的住院64例患者〔纽约心脏病协会(NYHA)心功能分级III〜IV级)随机分为治疗组32例和对照组32例，两组均按照《慢性心功能袞竭诊断治疗指南》进行治疗，对照组使用利尿剂、血管紧张素转换酶抑制剂(ACEI)及酌情使用硝酸脂类、洋地黄类药物，治疗组在此基础上加用心脉隆注射液8ml+5%葡萄糖注射液或0.9%氯化钠溶液100ml静脉滴注，2次/天，连用14天。比较两组治疗后的临床效果、左心室射血分数(LVEF)和B型脑钠(BNP)的变化。结果：对照组显效4例、有效14例、无效14例，治疗组显效8例、有效19例、无效5例，两组治疗效果间差异有统计学意义(P<0.05)。治疗后治疗组LVEF高于对照组，BNP水平低于对照组，差异均有统计学意义(P<0.05>。两组不良反应发生率比较，差异无统计学意义(P〉0.05>。结论:心脉隆注射液可降低冠脉三支病变患者心脏负荷，抑制神经内分泌激活，改善心功能。【关键词】冠心病；三支病变；慢性心力衰竭；心脉隆注射液；心功能【中图分类号】R54【文献标识码】A【文章编号】2095-1752(2015)32-0069-03ClinicalEffectofXinmailongInjectionintheTreatmentofHeartFailureamongTriplevesselcoronaryheartdiseaseLiangTian,ZhangQing.DepartmentofCardiology,XuzhouCityHospitalofTraditionalChineseMedicine,Xuzhou221009,Jiangsu,China【Abstract】ObjectiveToinvestigatethecurativeeffectandsafetyofXinmailonginjectionintreatingchronicheartfailure(CHF)amongtriplevesselcoronaryheartdisease.Methods64triplevesselcoronaryheartdiseasecombinedCHFpatientswithcardiacfunctionalgradingfromtoweredividedintotreatmentgroup(32cases)andcontrolgroup(32cases).ThetwogroupsweretreatedaccordingtoCHFtreatmentguide.ThecontrolgroupwasgivendiureticangiotensinconvertingenzymeinhibitorandappropriatelevelsofnitricacidlipideanddigitaloiddrugswhilethetreatmentgroupwasgivenadditionalintravenousdripofXinmailonginjectionand100ml5percentglucoseinjectionor0.9percentsodiumchloridesolutiononetimedailyfor14consecutivedays.Thechangesofclinicaleffectleftventricularejectionfraction(LVEF)andBNPaftertreatmentwerecomparedbetweenthetwogroups.ResultsInthecontrolgroup4casesweresignificantlyimprovedMeaseswereimprovedandMeaseswereinvalidwhileinthetreatmentgroup8casesweresignificantlyimproved19caseswereimprovedand5caseswereinvalid.Thedifferencebetweenthetwogroupswasstatisticallysignificant(P<0.05).AftertreatmenttheLVEFoftreatmentgroupwassignificantlyhigherthanthecontrolgroupandtheBNPwassignificantlylowerthanthecontrolgroup(P<0.05).Theadverseeffectrateofthetwogroupsshowednostatisticallysignificantdifference.ConclusionXinmailonginjectioncanlowercardiacloadofCHFamongtriplevesselcoronaryheartdiseaserestrainactivationofneuroendocrineandimproveheartfunction.【Keywords]Coronaryheartdisease;Triplevesseldisease;Chronicheartfailure;Xinmailonginjection;Heartfunction经冠脉造影或冠脉CTA明确诊断为冠脉三支病变患者，应该进行冠脉搭桥术、或置入多枚支架，但由于经济或其它原因，无法手术，这部分患者由于为进行有效血运重建，极易发生顽固性心衰。我们在常规使用扩冠、改善心功能等治疗的基础上，加用心脉隆注射液治疗，取得了一定临床疗效，现报道如下。i.资料与方法1.1一般资料选择我院心内科2012年1月〜2014年1月住院患者64例。随机分为治疗组和对照组。治疗组32例，其中男20例，女12例；平均年龄(60.3&plusmn;7.5)岁;平均病程(18.1&plusmn;8.5)年;心功能情况:111级21例，W级15例;对照组32例，其中男19例，女13例；平均年龄(59.8&plusmn;9.5)岁；平均病程(20.1&plusmn;8.0)年；心功能情...