丹参酮IIA联合卡维地洛治疗慢性心力衰竭的疗效及对患者血流动力学和氧化应激水平的影响

Curative Effect of Tanshinone IIA Combined with Carvedilol on Chronic Heart Failure and Its Influence on Hemodynamics and Oxidative Stress

摘要: 目的：探讨丹参酮IIA联合卡维地洛治疗慢性心力衰竭的临床疗效，并观察患者血流动力学和氧化应激水平的变化。方法：将114例慢性心力衰竭病人按随机抽签法分为治疗组和对照组，每组各57例，两组患者入院后均予以常规治疗，对照组予以口服卡维地洛片，治疗组在对照组基础上予以丹参酮IIA治疗。治疗4周后比较两组患者临床疗效及不良反应，且测定治疗前后射血–充盈血流逆转间期(FRI)、射血–充盈血流逆转流率(FRR)、左心室射血期峰值流率(FRPE)、血清超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、丙二醛(MDA)及脂质过氧化物(LPO)水平。结果：治疗组总有效率89.47%显著大于对照组的73.68% (P < 0.05)；治疗组治疗后FRI、MDA和LPO水平显著低于对照组，FRR、FRPE、SOD和TAC水平显著高于对照组，差异有统计学意义(P < 0.05)；两组患者均未出现特殊不良反应。结论：丹参酮IIA联合卡维地洛的应用可有效提高慢性心力衰竭的临床疗效，改善患者的血流动力学和氧化应激水平，具有一定的临床应用推广价值。

Abstract: Objective: To investigate the clinical curative effect of tanshinone IIA combined with carvedilol on chronic heart failure (CHF), and to observe the changes of hemodynamics and oxidative stress. Methods: 114 patients with CHF were divided into treatment group and control group by sortition randomization method, 57 cases in each group. The two groups were treated with routine treat-ment after admission. The control group was given oral carvedilol tablets. On this basis, the treatment group was given tanshinone IIA. After 4 weeks of treatment, the clinical curative effect and adverse reactions of the two groups were compared. The ejection-filled blood flow reversal interval (FRI), ejection-filled blood flow reversal rate (FRR), left ventricular ejection flow rate in period peak (FRPE), levels of serum superoxide dismutase (SOD), total antioxidant capacity (TAC), malondialdehyde (MDA) and lipid peroxide (LPO) before and after treatment were measured. Re-sults: The total effective rate of the treatment group was 89.47%, significantly higher than that of the control group (73.68%) (P < 0.05). The levels of FRI, MDA and LPO in the treatment group were significantly lower than those in the control group, while the levels of FRR, FRPE, SOD and TAC were significantly higher than those in the control after treatment (P < 0.05). There were no especially adverse reactions in either group. Conclusion: The application of tanshinone IIA combined with carvedilol can effectively improve the clinical curative effect for patients with chronic heart failure, and improve the hemodynamics and oxidative stress level, which has certain clinical application and promotion value.