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目的探讨丹参酮Ⅱ_A磺酸钠注射液联合甲磺酸酚妥拉明注射液治疗肺源性心脏病加重期的临床疗效。方法选取2016年7月—2017年7月西电集团医院收治的肺源性心脏病急性加重期患者78例为研究对象,按照随机分组设计将研究对象分为对照组和治疗组,每组各39例。对照组静脉滴注甲磺酸酚妥拉明注射液,20 mg加入到5%葡萄糖注射液250 mL中,1次/d。治疗组在对照组的基础上静脉滴注丹参酮Ⅱ_A磺酸钠注射液,50 mg加入到0.9%氯化钠溶液250 mL中,1次/d。两组患者连续治疗14 d。观察两组的临床疗效,比较两组的血液流变学指标、心功能指标和血气指标。结果治疗后,对照组和治疗组的总有效率分别为74.4%、92.3%,两组比较差异有统计学意义(P<0.05)。治疗后,两组全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、红细胞积压均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左心室射血分数(LVEF)、每搏输出量(SV)、一氧化碳(CO)均显著升高,平均肺动脉压(mPVP)均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组动脉血氧分压(pO_2)水平均显著升高,动脉血二氧化碳分压(pCO_2)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论丹参酮Ⅱ_A磺酸钠注射液联合甲磺酸酚妥拉明注射液治疗肺源性心脏病加重期具有较好的临床疗效,可改善心脏功能,改善血液流变学指标和血气指标,安全性较好,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of tanshinone Ⅱ_A sodium sulfonate injection combined with phentolamine mesylate injection in the treatment of aggravating pulmonary heart disease. Methods From July 2016 to July 2017, 78 patients with acute exacerbation of pulmonary heart disease admitted to the Xidian Hospital were enrolled in this study. According to randomized design, the subjects were divided into control group and treatment group 39 cases. Control group intravenous infusion of phentolamine mesylate injection, 20 mg added to 5% glucose injection 250 mL, 1 / d. The treatment group was given intravenous infusion of tanshinone Ⅱ_A sodium sulfonate on the basis of the control group, 50 mg of which was added to 250 mL of 0.9% sodium chloride solution once a day. Two groups of patients for 14 days of continuous treatment. The clinical curative effect of the two groups was observed. The blood rheology, cardiac function and blood gas index were compared between the two groups. Results After treatment, the total effective rates of the control group and the treatment group were 74.4% and 92.3%, respectively, with significant difference between the two groups (P <0.05). After treatment, the two groups of high blood viscosity of whole blood, low blood viscosity, plasma viscosity, fibrinogen, red blood cell backlog were significantly reduced, the same group before and after treatment was statistically significant (P <0.05); and the treatment group these The observation index was significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). After treatment, left ventricular ejection fraction (LVEF), stroke volume (SV) and carbon monoxide (CO) were significantly increased and mean pulmonary arterial pressure (mPVP) were significantly decreased in both groups before and after treatment with statistical differences (P <0.05). The improvement of these observation indexes in the treatment group was obviously better than that in the control group, the difference between the two groups was statistically significant (P <0.05). After treatment, the levels of arterial partial pressure of oxygen (pO_2) were significantly increased and the levels of arterial carbon dioxide partial pressure (pCO_2) were significantly decreased in the two groups (P <0.05), and the treatment group The improvement of these observation indexes was obviously better than that of the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Tanshinone Ⅱ_A sodium sulfonate injection combined with phentolamine mesylate injection in the treatment of exacerbation of pulmonary heart disease has a good clinical efficacy, can improve cardiac function, improve blood rheology and blood gas indicators, safety Better, with a certain clinical application value.