Abstract:

 Objective　To investigate the effects of Qili Qiangxin capsules combined with recombinant human brain natriuretic peptide (rhBNP) on the cardiac function and expressions of angiotensin Ⅱ (AngⅡ), Periostin, and growth arrest-specific protein 6 (GAS6) in patients with heart failure after acute myocardial infarction. Methods　A total of 82 patients with heart failure after acute myocardial infarction admitted to Liaocheng Third People's Hospital from April 2021 to April 2023 were simply randomly divided into two groups. In the control group, there were 19 males and 22 females, aged (59.35±8.64) years, 7 cases of grade II, 18 cases of grade III, and 16 cases of grade IV. In the observation group, there were 20 males and 21 females, aged (60.27±9.12) years, 9 cases of grade Ⅱ, 19 cases of grade Ⅲ, and 13 cases of grade Ⅳ. The control group received 1.5 μg/kg of rhBNP treatment for 7 days, and the observation group received oral administration of Qili Qiangxin capsules on the basis of the control group for 21 days (1.2 g/time, 3 times/day). The therapeutic effects, cardiac function [left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD)], AngⅡ, Periostin, and GAS6 levels before treatment and 21 days after treatment, and adverse reactions of the two groups were compared. t test and χ² test were performed. Results　The total effective rate of the observation group was higher than that of the control group [92.68% (38/41) vs. 75.61% (31/41)] (P<0.05). After treatment, the LVEF of the observation group [(54.56±5.15)%] was higher than that of the control group [(46.32±5.44)%], while the LVEDD [(42.34±6.18) mm], LVESD [(37.32±4.52) mm], AngⅡ [(112.37±9.58) ng/L], Periostin [(89.47±9.25) ng/L], and GAS6 [(13.41±3.68) μg/L] were lower than those of the control group [(51.17±5.26) mm, (40.92±4.11) mm, (118.13±9.61) ng/L, (98.54±9.72) ng/L, and (15.72±3.21) μg/L] (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group [12.20% (5/41)] and the control group [17.07% (7/41)] (P>0.05). Conclusion　The combination of Qili Qiangxin capsules combined with rhBNP has a significant therapeutic effect on heart failure after acute myocardial infarction, improving the heart function and reducing the Ang Ⅱ, Periostin, and GAS6 levels, which can be widely promoted in clinical practice.

Key words:

Myocardial infarction, Heart failure, Qili Qiangxin capsules, rhBNP, Heart function, AngⅡ

摘要：

目的　探讨芪苈强心胶囊联合重组人脑利钠肽（rhBNP）对急性心肌梗死后心力衰竭患者心功能及血管紧张素Ⅱ（AngⅡ）、骨膜蛋白（Periostin）、生长停滞特异性蛋白6（GAS6）表达的影响。方法　选择2021年4月至2023年4月聊城市第三人民医院收治的82例急性心肌梗死后心力衰竭患者，简单随机分为两组。对照组男19例，女22例，年龄（59.35±8.64）岁，心功能分级Ⅱ级7例、Ⅲ级18例、Ⅳ级16例；观察组男20例，女21例，年龄（60.27±9.12）岁，心功能分级Ⅱ级9例、Ⅲ级19例、Ⅳ级13例。对照组接受1.5 μg/kg rhBNP治疗7 d，观察组在对照组的基础上口服芪苈强心胶囊21 d（1.2 g/次，3次/d）。对比两组疗效，治疗前及治疗21 d后心功能［左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）］、AngⅡ、Periostin、GAS6水平，不良反应。行t检验、χ²检验。结果　观察组总有效率高于对照组［92.68%（38/41）比75.61%（31/41）］（P<0.05）。治疗后，观察组LVEF（54.56±5.15）%高于对照组（46.32±5.44）%，LVEDD（42.34±6.18）mm、LVESD（37.32±4.52）mm、AngⅡ（112.37±9.58）ng/L、Periostin（89.47±9.25）ng/L、GAS6（13.41±3.68）μg/L低于对照组［（51.17±5.26）mm、（40.92±4.11）mm、（118.13±9.61）ng/L、（98.54±9.72）ng/L、（15.72±3.21）μg/L］（均P<0.05）。观察组［12.20%（5/41）］和对照组［17.07%（7/41）］不良反应发生率比较，差异无统计学意义（P>0.05）。结论　芪苈强心胶囊联合rhBNP治疗急性心肌梗死后心力衰竭效果显著，能改善心功能，降低AngⅡ、Periostin、GAS6水平，可在临床推广。

关键词:

心肌梗死, 心力衰竭, 芪苈强心胶囊, rhBNP, 心功能, 血管紧张素Ⅱ