[1]张 悦,艾克荣.心衰保元汤治疗PCI术后射血分数保留型心力衰竭疗效及对患者血清Gal-3、sST2的影响[J].陕西中医,2025,46(1):51-55.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.010]
 ZHANG Yue,AI Kerong.Efficacy of Xinshuai Baoyuan decoction in the treatment of heart failure with preserved ejection fraction after PCI and its effect on serum Gal-3 and sST2[J].,2025,46(1):51-55.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.010]
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心衰保元汤治疗PCI术后射血分数保留型心力衰竭疗效及对患者血清Gal-3、sST2的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年1期
页码:
51-55
栏目:
临床研究
出版日期:
2025-01-05

文章信息/Info

Title:
Efficacy of Xinshuai Baoyuan decoction in the treatment of heart failure with preserved ejection fraction after PCI and its effect on serum Gal-3 and sST2
作者:
张 悦艾克荣
(西安市中医医院心血管病院,陕西 西安 710021)
Author(s):
ZHANG YueAI Kerong
(Cardiovascular Hospital,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)
关键词:
射血分数保留型心力衰竭 心衰保元汤 经皮冠状动脉介入术 半乳糖凝集素3 可溶性致癌抑制因子2 心功能
Keywords:
Heart failure with preserved ejection fraction Xinshuai Baoyuan decoction Percutaneous coronary intervention Ggalectin 3 Soluble carcinogenic inhibitor 2 Cardiac function
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2025.01.010
文献标志码:
A
摘要:
目的:探讨心衰保元汤治疗经皮冠状动脉介入术(PCI)后射血分数保留型心力衰竭(HFpEF)的疗效及对患者血清半乳糖凝集素3(Gal-3)、可溶性致癌抑制因子2(sST2)的影响。方法:将PCI后发生HFpEF的患者86例随机分为两组,对照组(n=43)接受常规西医治疗,观察组(n=43)在对照组基础上加用心衰保元汤治疗,疗程为12周。记录两组临床疗效,比较两组治疗前后相关心功能指标、超声心动图指标、血清Gal-3、sST2水平。比较两组治疗后随访6个月时的心血管不良事件发生率。结果:观察组临床总有效率显著高于对照组(P<0.05)。与治疗前比较,治疗后两组Lee氏心衰积评分、心功能 NYHA 分级、血清N 末端脑钠肽原(NT-proBNP)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室质量指数(LVMI)均显著降低(P<0.05),且观察组降低程度高于对照组(P<0.05); 观察组6 min步行试验距离、左室射血分数(LVEF)、舒张早期/晚期二尖瓣血流峰值(E/A)均增加(P<0.05),且观察组增加程度高于对照组(P<0.05)。与治疗前比较,治疗后两组血清Gal-3、sST2水平均显著降低(P<0.05),且观察组降低程度高于对照组(P<0.05)。观察组随访6个月时心血管不良事件发生率显著低于对照组(P<0.05)。结论:在西医治疗基础上加用心衰保元汤可有效提高PCI后HFpEF的临床疗效,抑制心室重构,改善心脏功能,下调血清Gal-3、sST2表达水平,从而有利于降低心血管不良事件发生率。
Abstract:
Objective:To investigate the efficacy of Xinshuai Baoyuan decoction in the treatment of heart failure with preserved ejection fraction(HFpEF)after percutaneous coronary intervention(PCI)and its effect on serum galectin 3(Gal-3)and soluble oncogenic inhibitor 2(sST2).Methods:A total of 86 patients with HFpEF after PCI were randomly divided into two groups:the control group(n=43)received conventional western medicine treatment,and the observation group(n=43)was treated with Xinshuai Baoyuan decoction on the basis of the control group,and the course of treatment was 12 weeks.The clinical efficacy of the two groups was recorded,and the relevant cardiac function indexes,echocardiographic indicators,serum Gal-3 and sST2 levels were compared between the two groups before and after treatment.Results:The total clinical effective rate of observation group was higher than control group(P<0.05).Compared with before treatment,Lee's heart failure score,NYHA grade,serum N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular mass index(LVMI)were significantly reduced in the two groups after treatment(P<0.05),and the reduction degree in the observation group was higher than that in the control group(P<0.05).The peak blood flow(E/A)of advanced mitral valve increased(P<0.05),and the increase degree in the observation group was higher than that in the control group(P<0.05).Compared with before treatment,the serum levels of Gal-3 and sST2 in the two groups were significantly decreased after treatment(P<0.05),and the reduction degree in the observation group was higher than that in the control group(P<0.05).Conclusion:On the basis of Western medicine treatment,the addition of Xinshuai Baoyuan decoction can effectively improve the clinical efficacy of HFpEF after PCI,inhibit ventricular remodeling,improve cardiac function,and down-regulate the expression levels of serum Gal-3 and sST2,which is conducive to reducing the incidence of cardiovascular adverse events.

参考文献/References:

[1] 周江荣,冯俊,高玉,等.急性ST段抬高型心肌梗死患者经皮冠状动脉介入术术后主要心血管不良事件发生的影响因素及血清N末端脑钠肽前体、胱抑素-C、血小板淋巴细胞比值的预测价值研究[J].陕西医学杂志,2024,53(4):523-526,539.
[2] 李汶玲,陈娇娇.血清前白蛋白和正五聚蛋白 3 水平对AMI患者PCI术后心力衰竭发生的预测价值[J].新疆医科大学学报,2023,46(5):643-647.
[3] 陶成敏,谢伟,徐晓东.沙库巴曲缬沙坦对AMI急诊PCI术后射血分数保留型心力衰竭患者的疗效及对心血管事件的影响[J].中国循证心血管医学杂志,2024,16(3):316-319,334.
[4] 李萌,蒋书云,解文静,等.急性ST段抬高心肌梗死患者PCI术后心力衰竭的多项因素研究分析[J].中国分子心脏病学杂志,2022,22(5):4939-4943.
[5] 许海华,徐明星,周昱和,等.急性心肌梗死患者行PCI术后心力衰竭的影响因素及风险预测模型研究[J].中国循证心血管医学杂志,2024,16(2):205-207,226.
[6] 钟妮娜,向小芳.参芪利心汤联合达格列净对急性心肌梗死直接PCI术后心力衰竭的疗效研究[J].四川中医,2024,42(9):102-107.
[7] 陆滢屹,陈丽雯,柴钰,等.强心方联合沙库巴曲缬沙坦对慢性心力衰竭患者中医症候、心室重构及运动耐力的影响[J].陕西中医,2023,44(8):1052-1055.
[8] 中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.
[9] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789.
[10] 中华中医药学会.中医内科常见病诊疗指南(西医疾病部分)心力衰竭[J].中国中医药现代远程教育,2011,9(18):145-147.
[11] 王蔚文.临床疾病诊断与疗效判断标准[M].北京:科学技术文献出版社,2010:158-159.
[12] LEE D C,JOHNSON R A,BINGHAM J B,et al.Heart failure in outpatients:A randomized trial of digoxin versus placebo[J].N Engl J Med,1982,306(12):699-705.
[13] 吴兴,王晓萍,张伟民.6 min 步行试验在慢性心力衰竭中的应用[J].临床军医杂志,2007,35(1):122-123.
[14] 陈丽妃,黎蓉,梁红娟.N末端B型利钠肽原联合炎性因子变化水平对射血分数保留心力衰竭患者预后预测价值[J].中国心血管病研究,2023,21(12):1099-1105.
[15] 张真路.生物标志物在射血分数保留心力衰竭诊疗中的价值[J].中华检验医学杂志,2023,46(12):1224-1234.
[16] 卢鹏飞,张波,李永旺,等.急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗术后不同左心室射血分数患者的临床特征及预后多中心比较研究[J].中国循环杂志,2019,34(11):1068-1073.
[17] 盛晟,李玲秀,程丹,等.扶阳益心方治疗气虚血瘀型射血分数保留心力衰竭患者临床疗效研究[J].辽宁中医药大学学报,2024,26(8):200-204.
[18] 刘永成,石玉姣,刘思雨,等.300例射血分数保留心力衰竭患者的中医证候分布规律[J].环球中医药,2024,17(8):1469-1475.
[19] 国家老年医学中心国家老年疾病临床医学研究中心,中国老年医学学会心血管病分会,北京医学会心血管病学会影像学组.中国成人心力衰竭超声心动图规范化检查专家共识[J].中国循环杂志,2019,34(5):422-436.
[20] 关静,黄凡克,周伊璐,等.黄芪甲苷抗心力衰竭患者缺血缺氧性心肌损伤的机制研究进展[J].实用心脑肺血管病杂志,2023,31(9):111-114.
[21] 王天宝,马冬璞,刘毓,等.黄芪甲苷对急性心力衰竭大鼠心肌线粒体能量代谢的影响[J].广州中医药大学学报,2022,39(4):884-891.
[22] 王超,孙浩栋,魏凤凤,等.人参皂苷Rb1改善心力衰竭的研究进展[J].现代药物与临床,2023,38(3):731-737.
[23] 业康,朱韵辰,蔡犇,等.红花多糖药理学作用研究进展[J].中医药导报,2021,27(8):115-119.
[24] 张军彦,张超超,王付启.丹参川芎嗪联合沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能、血管内皮功能的影响[J].河北中医,2023,45(2):245-248,252.
[25] 邵玲,纪丹.慢性心力衰竭中医辨证分型与血清sST2、Gal-3、GDF-15水平的相关性研究[J].四川中医,2024,42(8):99-102.
[26] 刘聪,赵文超,赵立月.急性冠脉综合征患者血清Gal-3、TPOAb、TP53表达及PCI术后心血管事件的危险因素分析[J].中国循证心血管医学杂志,2023,15(8):1004-1007.
[27] 王鑫,杨萍,陈碧莲,等.老年心力衰竭患者血清sST2和NT-proBNP与血流动力学的相关性[J].中国医师杂志,2024,26(1):108-111.
[28] 黄栢权,钟丁亮,杨亦炳.沙库巴曲缬沙坦钠片对慢性心力衰竭患者心室重构及miR-423-5p、sST2的影响[J].河北医科大学学报,2024,45(1):70-75.
[29] 周文杰,曹勇,丁晓云,等.血清Gal-3、sST2水平对急性ST段抬高型心肌梗死PCI后心力衰竭的预测价值[J].山东医药,2022,62(28):29-33.

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(202224JC-YBMS-753)
更新日期/Last Update: 2025-01-09