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Objective:To explore the correlation between Traditional Chinese Medicine (TCM) excessive patterns and clinical characteristics of acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated with chronic pulmonary heart disease (CPHD) in high altitude environment.Methods:Patients with acute exacerbation of COPD complicated with CPHD admitted to the Pulmonology Department of Qinghai Provincial Hospital of Traditional Chinese Medicine from December 2016 to November 2017 were selected. Demographic data and clinical medical characteristics data of the patients were collected, and TCM patterns differentiation was conducted. The correlation between each pattern type and clinical characteristics and all collected laboratory indexes were analyzed by multivariate logistic regression.Results:Phlegm obstructing lung pattern showed a negative correlation relationship with mMRC score [ OR=0.419, 95% CI (0.219-0.802), P=0.009], PCT [ OR=8.132×10 -11, 95% CI (1.632×10 -16-4.1×10 -5), P<0.001], Hb [ OR=0.971, 95% CI (0.952-0.989), P=0.002] and PaCO 2[ OR=0.914, 95% CI (0.853-0.980), P=0.011]; turbid phlegm obstructing lung pattern showed a negative correlation relationship with gender(0 male, 1 female) [ OR=0.427, 95% CI (0.204-0.892), P=0.024], Hb [ OR=0.960, 95% CI (0.945-0.975), P<0.001], and there was a positive correlation relationship with LVEF [ OR=1.061, 95% CI (1.006-1.118), P=0.028]; phlegm-heat obstructing lung pattern showed a negative correlation relationship with Hb [ OR=0.950, 95% CI (0.927-0.974), P<0.001]and cardiac function grade [ OR=0.468, 95% CI (0.248,0.881), P=0.019], and there was a positive correlation relationship with PCT [ OR=1.118×10 8, 95% CI (1.466×10 4-8.523×10 11), P<0.001] and D-D [ OR=2.283, 95% CI (1.300-4.010), P=0.004]; there was a negative correlation between phlegm and stasis blocking lung pattern with cardiac function grade[ OR=0.309, 95% CI (0.167-0.570), P<0.001], and there was a positive correlation relationship with Hb[ OR=1.060, 95% CI (1.042-1.078), P<0.001]; there was a negative correlation between wet phlegm and blood stasis heat pattern with PCT [ OR=1.266×10 -13, 95% CI (1.658×10 -21-0.1×10 -4), P<0.001], SaO 2 [ OR=0.934, 95% CI (0.892-0.979), P=0.004], LVEF [ OR=0.896, 95% CI (0.826-0.971), P=0.008], D-D [ OR=0.030, 95% CI (0.002-0.508), P=0.015], and there was a positive correlation relationship with CRP [ OR=1.042, 95% CI (1.018-1.067), P<0.001], RBC [ OR=3.411, 95% CI (1.684-6.910), P<0.001], cardiac function grade [ OR=8.573, 95% CI (2.410-30.504), P<0.001], pulmonary arterial pressure difference [ OR=2.091, 95% CI (1.243-3.516), P=0.005]. Conclusions:Male patients are more prone to phlegm and turbidities than female patients. PCT and D-D were the main risk factors of phlegm-heat obstruction syndrome. Elevated hemoglobin is a risk factor for patients with phlegm stasis and lung syndrome. Heart function classification is the main risk factor of phlegm-dampness-stasis heat syndrome.
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Objective To study and analyze the clinical effect of valsartan on chronic pulmonary heart disease. Methods 100 cases of heart failure patients with pulmonary heart disease treated in our hospital from January 2015 to October 2016 were selected and randomly divided into the control group and the experimental group,50 cases in each group.Two groups of patients were given the basic treatment of diuretics,low salt diet, digitalis and nitrates,so as to ensure that the patients had enough rest.Patients in the control group were treated with benazepril,and the patients in the experimental group were treated with valsartan.The clinical indexes of the experimental group and the control group were compared and analyzed. Results After corresponding treatment,the number of effective treatment was 48 cases.In the control group,the total effective number was 41 cases. The effective rate of the control group (82.0％) was significantly lower than the experimental group(96.0％) (P<0.05).The incidence of adverse reactions in the experimental group was 8.0％, and the fatality rate was 10.0％. The incidence of adverse reactions in the control group was 10.0％, and the fatality rate was 12.0％.There was no significant difference between two groups.After treatment,the indexes of LVEDD and LVESD in the experimental group were better than those in the control group,with statistical significance(P<0.05).Conclusion Valsartan was effective in the treatment of chronic pulmonary heart disease with heart failure.It can improve the treatment efficiency and security in a certain extent,and has the significance of further popularization and application.
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AIM To observe the effect of Safflower Injection (safflower yellow) combined with alprostadil and sildenafil in the treatment of chronic pulmonary heart disease (chronic cor pulmonale) complicated with pulmonary hypertension.METHODS Two hundred and twenty-three cases of chronic pulmonary heart disease complicated with pulmonary hypertension patients were randomly divided into two groups,the control group of one hundred and eleven cases in conventional therapy plus alprostadil and sildenafil,one hundred and twelve cases in the treatment group were treated with Safflower Injection on the basis of the control group.The efficacy and side effects in two groups were observed.RESULTS The total effective rate of the treatment group was significantly higher than that of the control group.Pulmonary artery systolic pressure (SPAP),pulmonary arterial mean pressure (mPAP) and pulmonary artery diastolic blood pressure (DPAP) in two groups,compared with those before the treatment,were significantly decreased,left ventricular shoot ejection fraction (LVEF),compared with those before treatment,was significantly increased;SPAP,mPAP and DPAP of treatment group after the treatment were decreased significantly as compared with the control group,LVEF was significantly increased.Arterial partial pressure of oxygen (PaO2) and arterial oxygen saturation (SaO2) in two groups,compared with those before the treatment,were significantly increased,carbon dioxide partial pressure (PaCO2),compared with those before the treatment,was significantly decreased;after treatment in the treatment group,PaO2 was significantly increased as compared with the control group.Blood high shear viscosity,whole blood viscosity at low shear,plasma viscosity,red blood cell pressure volume and platelet aggregation rate in two groups were significantly lower than those before the treatment;whole blood high shear viscosity,whole blood viscosity of low shear,plasma viscosity and platelet aggregation rate in the treatment group,compared with the control group,were decreased significantly.High sensitive C reactive protein (hsCRP),creatine kinase (CK-MB) and cardiac troponin Ⅰ (TnⅠ) in two groups,compared with those before the treatment,were significantly reduced;after the treatment,hs-CRP,CK-MB and TnⅠ in the treatment group,compared with the control group,were decreased significantly.There was no difference in incidence of adverse reactions between the two groups.There were no significant changes in liver and renal functions before and after the treatment in two groups.CONCLUSION Safflower Injection combined with alprostadil and sildenafil in the treatment of chronic pulmonary heart disease complicated with pulmonary hypertension has a good curative effect.
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Objective To investigate the correlation between the gene polymorphism of homocysteine metabolic enzyme cystathionine β-synthase(CBS) 844ins68,N5,10-methylenetetrahydrofolate reductase(MTHFR) C677T and chronic pulmonary heart disease(CPHD).Methods A total of 230 patients with CPHD in observation group were selected from January 2014 to November 2016 in the Second People's Hospital of Xinxiang City,and 235 healthy subjects in healthy control group were selected at the same time.The lung function test was performed with lung function instrument,and the percentage of the forced expiratory volume in one second to predicted value(FEV1％ pred) and the forced expiratory volume in one second to forced vital capacity(FEV1％) value were recorded in the two groups.The fasting ulnar venous blood was collected from the patients in the observation group on the next morning after hospitalization and the subjects in the control group on the morning of health examination.The levels of plasma homocysteine (Hcy),fasting blood glucose (FBG),triacylglycerol (TG),total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were detected.The DNA was extracted from the whole blood cells.The CBS 844ins68 polymorphism was detected by polymerase chain reaction genotyping.The MTHFR C677T polymorphism was detected by restriction fragment length polymorphism polynerase chain reaction.Results There was no significant difference in the FBG level between the two groups (P ＞ 0.05).The levels of Hcy,TG,TC and LDL-C in the observation group were significantly higher than those in the healthy control group (P ＜ 0.05),and the FEV1 and FEV1％ pred were significantly lower than those in the healthy control group (P ＜ 0.05).There were two genotypes of CBS 844ins68 in the two groups.The genotype frequencie of DD and DI in the observation group was 91.74％ and 8.26％,and the allele frequency of D and I was 95.87％ and 4.13％ respectively.The genotype frequency of DD and DI in the healthy control group was 94.04％ and 5.96％,and the allele frequency of D and I was 97.02％ and 2.98％ respectively.There was no significant difference in genotype and allele frequency distribution between the two groups (x2 =0.935,0.901;P ＞ 0.05).Three genotypes of MTHFRC677T were detected after enzyme digestion in the two groups.The genotype frequency of CC,CT and TT in the healthy control group was 27.66％,48.94％ and 23.40％;and the allele frequency of C and T was 52.13％ and 47.87％ respectively.The frequency of TT genotype and T allele in the observation group was significantly higher than that in the healthy control group (x2 =7.730,7.326;P ＜ 0.05).Conclusions Hcy level increasing may be a risk factor for CPHD.The polymorphisms of CBS 844ins68 gene may be unrelated to the occurrence of CPHD.The polymorphism of the MTHFR C677T gene may contribute to CPHD by affecting Hcy level.The T allele of MTHFR C677T may be a risk factor for CPHD,and the MTHFRC677T gene may be a genetic predisposition to CPHD.
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Objective To explore the correlation between cardiac function classification and homocysteine (HCY) ,N-terminal pro-brainnatriureticpeptide(NT-proBNP),fibrinogen(Fbg),D-dimer(D-D) in patients with chronic pulmonary heart disease (CPHD) .Methods A total of 135 cases of CHPD were divided into 4 groups by cardiac function classification of New York Heart Association(NYHA):NYHA class Ⅰ group(group A ,33 cases) ,NYHA class Ⅱ group(group B ,39 cases) ,NYHA class Ⅲ group (group C ,36 cases) ,NYHA class Ⅳ group(group D ,27 cases) .Meanwhile 50 healthy subjects were recruited into HC group .The level of HCY ,NT-proBNP ,Fbg and D-D were detected and compared between different groups .Receiver operating characteristic (ROC) curves were drawn ,the area under ROC curves(AUCs) were calculated to assess the diagnostic value of each item ,the cor-relation between cardiac function classification and HCY ,NT-proBNP ,Fbg ,D-D in CHPD was analyzed .Results Compared with HC group ,the level of HCY ,Fbg and D-D in group A didn′t rose significantly(P>0 .05) .The level of HCY ,NT-proBNP ,Fbg and D-D in group B ,C ,D were significant with those of the control group(P<0 .05) .NT-proBNP increased higher in CHPD as the du-ration of cardiac function classification of NYHA processed (P<0 .05) .The AUCs of HCY ,NT-proBNP ,Fbg ,D-D were respective-ly 0 .710 ,0 .919 ,0 .782 ,0 .864 in CHPD patients .There were significant correlations between cardiac function classification of NY-HA and HCY ,NT-proBNP ,Fbg ,D-D(P< 0 .01) .Conclusion The level of HCY ,NT-proBNP ,Fbg ,D-D could be considered as monitoring and diagnostic indexes of CHPD .
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Objective To explore the correlation between cardiac function classification and homocysteine (HCY) ,N-terminal pro-brainnatriureticpeptide(NT-proBNP),fibrinogen(Fbg),D-dimer(D-D) in patients with chronic pulmonary heart disease (CPHD) .Methods A total of 135 cases of CHPD were divided into 4 groups by cardiac function classification of New York Heart Association(NYHA):NYHA class Ⅰ group(group A ,33 cases) ,NYHA class Ⅱ group(group B ,39 cases) ,NYHA class Ⅲ group (group C ,36 cases) ,NYHA class Ⅳ group(group D ,27 cases) .Meanwhile 50 healthy subjects were recruited into HC group .The level of HCY ,NT-proBNP ,Fbg and D-D were detected and compared between different groups .Receiver operating characteristic (ROC) curves were drawn ,the area under ROC curves(AUCs) were calculated to assess the diagnostic value of each item ,the cor-relation between cardiac function classification and HCY ,NT-proBNP ,Fbg ,D-D in CHPD was analyzed .Results Compared with HC group ,the level of HCY ,Fbg and D-D in group A didn′t rose significantly(P>0 .05) .The level of HCY ,NT-proBNP ,Fbg and D-D in group B ,C ,D were significant with those of the control group(P<0 .05) .NT-proBNP increased higher in CHPD as the du-ration of cardiac function classification of NYHA processed (P<0 .05) .The AUCs of HCY ,NT-proBNP ,Fbg ,D-D were respective-ly 0 .710 ,0 .919 ,0 .782 ,0 .864 in CHPD patients .There were significant correlations between cardiac function classification of NY-HA and HCY ,NT-proBNP ,Fbg ,D-D(P< 0 .01) .Conclusion The level of HCY ,NT-proBNP ,Fbg ,D-D could be considered as monitoring and diagnostic indexes of CHPD .
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OBJECTIVE: To explore the changes of pulmonary hemodynamic parameters in pneumoconiosis patients examined by echocardiography and its clinical significance. METHODS: Using simple random sampling method,102 male patients with pneumoconiosis were chosen and divided into simple pneumoconiosis group( 70 cases) and pneumoconiosis combined with chronic pulmonary heart disease( CPHD) group( 32 cases). Forty healthy male volunteers were chosen as the control group. The right heart morphological indexes including the diameters of main pulmonary artery( MPA),right ventricular outflow tract( RVOT),right ventricle( RV),the tricuspid regurgitation velocity and the time velocity integral of the right ventricular outflow tract were measured with echocardiography. The right atrial pressure was estimated and the pulmonary artery systolic pressure( PASP),the pulmonary vascular resistance( PVR) and the ratio of pulmonary artery acceleration time / right ventricular ejection time( PAAT / RVET) were calculated. RESULTS: The diameters of MPA,RVOT and RV in pneumoconiosis combined CPHD group were longer than those of the control group and simple pneumoconiosis group( P <0. 05). The RVOT diameter of simple pneumoconiosis group was longer than that of the control group( P < 0. 05). The indexes of PASP and PVR in pneumoconiosis combined CPHD group were higher than those of the control group and simple pneumoconiosis group,respectively( P < 0. 05). The indexes of PASP and PVR in simple pneumoconiosis group were higher than those of the control group( P < 0. 05). The indexes of PAAT / RVET in pneumoconiosis combined CPHD group and simple pneumoconiosis group were lower than that of the control group,respectively( P < 0. 05). There was no statistical significance difference found in MPA and RV diameters between simple pneumoconiosis group and the control group( P > 0. 05). CONCLUSION: Our results indicate that monitoring the pulmonary hemodynamic parameters of pneumoconiosis patients by using echocardiography can provide basis for planning early intervention measures in clinic.
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Objective To observe the clinical efficacy and safety of Shuxuetong in treatment of paroxysmal atrial fibril-lation in patients with chronic pulmonary heart disease. Methods A randomized single-blinded study was performed. A to-tal of 91 patients with paroxysmal atrial fibrillation and chronic pulmonary heart disease were randomly divided into treat-ment group (n=45) and control group (n=46). The treatment group was received Shuxuetong and clopidogrel treatment for 14 days. The control group was given routine treatment plus clopidogrel 75 mg orally. The average time of cardioversion of parox-ysmal atrial fibrillation was detected within 48 hours. The cardioversion rate of paroxysmal atrial fibrillation and the total effi-ciency were detected after14 days. The serum D-Dimer was detected before and 14 days after treatment . Liver and kidney function and adverse drug reactions were also detected. Results There was no significant difference in average time of car-dioversion of paroxysmal atrial fibrillation in 48 h between two groups (h:12.62±2.32 vs 13.32±2.25,t=1.461). The cardiover-sion rates were 86.67%(39/45) and 82.22%(37/45) at 48 h and 14 d in treatment group, which were significantly higher than those of control group [69.56%(32/46) and 60.87(28/46)]. The D-Dimer at 14 d after treatment was significantly lower in treatment group [(2.05±0.34)mg/L] than before treatment[(2.61±0.27)mg/L], also than that of control group[(2.53±0.31)mg/L]. There were no abnormal liver and kidney function and no adverse reactions between two groups. Conclusion Shuxuetong can significantly prevent the recurrence of paroxysmal atrial fibrillation in patients with chronic pulmonary heart disease, and help to reduce the risk of thromboembolism. It is safe and effective.
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Objective To observe the effect of Shuxuetong injection in the improvement of heart and lung function on chronic pulmonary heart disease patients with basic treatment .Methods The control group was given low flow oxygen ,sensi-tive antibiotics for infection control ,and other treatments such as cough relief ,sputum reduction ,and antispasmodic treat-ment .Treatment group was given 6 ml Shuxuetong injection once a day for 14 days as 1 treatment period .Results The total effective rate of treatment group was 93 .75% ,while that of total control group was 67 .39% (P<0 .05) from Chi square test (χ2 =11 .36 ,P=0 .00) .All indexes of blood rheology of treatment group significantly improved compared with self control at an earlier time (P<0 .05) and control group (P<0 .01) .Improvement of the index of pulmonary function between two groups was significant difference(P<0 .01) .Conclusion Shuxuetong injection as an adjuvant treatment would improve microcircula-tion ,reduce inflammation ,and improve patient outcomes .Therapy combined with Shuxuetong injection in the treatment of chronic pulmonary heart disease could significantly improve the efficacy ,therefore ,which would be worth of clinical use .
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OBJECTIVE:To observe the clinical efficacy and safety of Shenfu injection combined with Danshen chuanxiongqin injection in the treatment of chronic pulmonary heart disease patients with heart failure. METHODS:Totally 100 chronic pulmonary heart disease patients with heart failure were randomly divided into observation group and control group. Patients in control group were given routine treatment,including antispasmodic asthma,low-flow oxygen therapy,anti-inflammatory,diuretic strong heart, maintaining the body water,electrolyte balance,vasoactive drugs and dopamine,etc. Patients in observation group were given Shenfu injection 50 ml and Danshen chuanxiongqin injection 10 ml adding into 5% glucose injection 250 ml based on the treatment of control group,iv,once a day. The course of both was 14 d. The clinical data was observed,including clinical efficacy,improve-ment time of signs and symptoms,p(O2),p(CO2),SV,LVEF,LVEDD,LVSD and the incidence of adverse reactions before and after treatment. RESULTS:The total effective rate in observation group was significantly higher than control group,the remission time of cyanosis,slowing time of heart rate and subsided time of swelling were significantly shorter than control group,with signif-icant differences(P<0.05). After treatment,the p(O2),p(CO2),SV,LVEF,LVEDD and LVSD in 2 groups were significantly bet-ter than before,and observation group was better than control group,with significant differences(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the treatment,Shenfu injection combined with Danshen chuanxion-gqin injection has better clinical efficacy than routine treatment in the treatment of chronic pulmonary heart disease patients with heart failure,with similar safety.
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OBJECTIVE:To observe clinical efficacy and safety of adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter. METHODS:100 cas-es of chronic pulmonary heart disease heart failure complicated with rapid atrial fibrillation and atrial flutter were randomly divided into observation group and control group,with 50 cases in each group. The control group was given conventional treatment,and the observation group was additionally given diltiazem orally,30 mg/time,once a day,and adenosine cyclophosphate 180 mg add-ed into 5% Glucose injection 200 ml intravenously,once a day,for 10 days,on the basis of conventional treatment. The heart rate,the pressure of pulmonary artery and left ventricular ejection fraction(LVEF)before and after treatment,and clinical efficacy were observed in two groups. RESULTS:After treatment,clinical symptoms of 43 cases of observation group and 31 cases of con-trol group improved significantly,and heart rate were satisfactory,with statistical significance(P<0.05). The decrease of pulmo-nary arterial pressure and LVEF in observation group were improved significantly,compared to control group,with statistical signif-icance (P<0.05). The bradycardia,hypotension,the exacerbation of asthma and heart failure and other side effects hadn’t been found in 2 groups. CONCLUSIONS:Adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter can significantly improve cardiac function,control heart rate and promote the improvement of disease condition with good safety.
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Objective To explore the effect and mechanism of atorvastatin on pulmonary hypertension (PAH) in chronic pulmonary heart disease.Methods Seventy eight patients with chronic pulmonary heart disease were randomly signed into treating group and observing group.Forty healthy people were picked up from people taking physical examination at the same stage as control group.Patients in observing group were given routine treatment,and patients in treating group were given atorvastatin (20 mg/d) supplement beside routine treatment.Pulmonary function,ultrasound cardiogram,plasma interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured before and after 24 weeks of treatment.Results There were no difference in terms of forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FVC),pulmonary arterial pressure (PAP) and the levels of IL-6 and TNF-α between the observing group and treating group before treatment(P ＞ 0.05).While there were significant difference in terms of the serum levels of IL-6,TNF-α and PAP of treating group,observing group and normal control group at before treatment (IL-6:(106.61 ± 31.34) ng/L,(105.33 ± 30.16) ng/L,(73.81 ± 31.12) ng/L,F =67.17 ; TNF-α:(19.41 ± 10.21) ng/L,(18.25 ± 11.37) ng/L,(14.82 ± 4.33) ng/L,F =15.43 ; PAP:(58.33 ± 8.95) mmHg,(56.04 ± 8.57) mmHg,(15.88 ±7.01) mmHg,F =88.78;P =0.00),and these levels in observing and treating group were higher than those in normal control group(P ＜0.01).After 24 weeks treatment,the IL-6,TNF-α,PAP in the treating group were (73.90 ± 27.12) ng/L,(14.91 ± 5.35) ng/L and (45.96 ± 5.61) mmHg respectively,significantly lower than those in observing group ((103.00 ± 28.12) ng/L,(17.22 ± 7.17) ng/L and (53.11 ± 9.21) mmHg respectively; P =0.025,0.045 and 0.031 respectively).The pulmonary function indexes including FEV1 and FEV1/FVC in treating group were much better than those in observing group at 24 weeks treatment (FEV1:(57.85±10.31)％ vs.(43.9±31.33)％;FEV1/FVC:(57.83±10.38)％ vs.(47.97± 14.79) ％ ;P =0.001,0.024 respectively).Conclusion Atorvastatin can effectively improve the life quality and pulmonary function,decrease PAP of patients with chronic pulmonary heart disease,and the mechanism may be related to the inhibition of inflammation in pulmonary vessels.
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Objective To evaluate the clinical effect of clopidogrel combined with low molecular weight heparin (LMWH) on chronic pulmonary heart disease in patients with acute exacerbation.Methods Eighty cases of patients with chronic pulmonary heart disease with exacerbation were randomly divided into treatment group (40 cases) and control group (40 cases).Patients in control group were administrated with conventional treatment including infection control,cough,phlegm,relieving spasm and asthma,persistent low flow oxygen,maintain airway patency,strong heart,diuresis,anti arrhythmia.Patients in treatment group were treated with subcutaneous injection of low molecular weight heparin and oral clopidogrel therapy beside routine treatment.Plasma prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time (TT),fibrinogen(Fb) and pulmonary function(FEVI) were measured.Results (1) After treatment,Fb in treatment group and control group were (3.92 ± 1.11) g/L,(4.54 ± 1.41) g/L respectively.While PT,APTT,TT and FEVI in treatment group were (13.02 ± 1.52) s,(33.21 ± 4.03) s,(14.03 ± 2.52) s,(45.73 ± 7.38) ％ respectively,significantly higher than the control group ((11.31 ± 2.01) s,(30.13 ± 3.59) s,(12.88 ± 2.11) s and (40.12 ± 6.99) ％,P ＜0.05).(2) In control group,FEVI after treatment significantly improved than that of before treatment (t =4.821 ; P ＜ 0.05),while PT,APTT,TT were no significant changes (P ＞ 0.05).PT,APTT,TT,FEVI in treatment group were significantly improved after treatment than that of before treatment(P ＜ 0.05).(3) The clinical effective rate in treatment group was 80.0％ (32/40),higher than that in control group (65.0％(26/40) x2 =4.815; P ＜0.05).Conclusion The therapy scheme of clopidogrel combined with low molecular heparin calcium is proved to be an efficacy method for reducing sputum viscosity,antiinflammatory,anti allergic effect,platelet aggregation,increasing pulmonary blood flow,improving the condition of patients with pulmonary heart diseasethe.And its clinical effect is significant,worthy to promote and apply.
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Objective To investigate the clinical effect of heart failure recombinant human brain natriuretic peptide (rhBNP) in treatment of chronic pulmonary heart disease (CPHD).Methods Fifty-six CPHD patients with heart failure were randomly divided into control and research group who were hospitalized from January 2010 to December 2011.Patient in two groups were given oxygen,anti-infection,nutritional support and complications treatment.In addition patients in the treatment group was treated with rhBNP.Clinical symptoms,signs and cardiac,pulmonary function of two groups were recorded.Results The pulmonary artery pressure in treatment group were (39.7 ± 6.2) mm Hg and (26.5 ± 3.8) mm Hg before and after treatment,and the difference was significant(t =14.992,P =0.000).The pulmonary artery pressure in control group were (38.4 ±5.1) mm Hg and (31.5 ±4.5) mm Hg before and after treatment,and significant difference were seen (9.378,P =0.000).In addition,pulmonary artery pressure were different between in treatment and control group(t =-9.742,P =0.000).The level of BNP in treatment group was (873.0 ± 12.9) ng/L and (382.0 ± 11.4) ng/L,there was significant difference(t =353.627,P =0.000) ;While in control group,the level of BNP was (862.0 ± 12.3) ng/L and (568.0 ± 12.6) ng/L before and after treatment,and the difference was significant(t =156.135,P =0.000).And there was sinificant difference between the two groups after treatment (t =-103.490,P =0.000).The left ventricular ejection fraction before and after treatment in treatment group was (38 ±9)％ and (65 ±8)％,and the difference was significant(t =-23.056,P =0.000) ;While in control group,the Left ventricular ejection fraction was (32 ± 7) ％ and (47 ± 5) ％ before and after treatment,and the difference was significant (t =-16.485,P =0.000).And the difference between two groups was significant(t =18.308,P ＜ 0.01).24 h urine volume in treatment group was (0.9 ± 0.4) L and (1.6 ± 0.3) L before and after treatment,and the difference was significant(t =-17.320,P =0.000) ;While in control group,24 h urine volume was(0.9 ± 0.2) L and (1.0 ± 0.6) L before and after treatment,and the difference was significant (t =-5.250,P =0.000).And the difference between two groups was significant (t =6.592,P =0.000).The total effective rate in treatment was 82.2％ (23/28),higher than that in the control group (57.1％ (16/28),and the difference was significant(x2 =4.139,P ＜ 0.05).Conclusion rhBNP can improve heart function of CPHD patients with heart failure.
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Objective To observe the influence and safety of rosuvastatin on high sensitive C-reactive protein (hs-CRP),Endothelin-1 (ET-1),N-terminal pro-brain natriuretic peptide (NT-proBNP),pulmonary artery systolic pressure(PASP) and cardiac function in patients with chronic pulmonary heart disease.Methods Eighty patients with chronic pulmonary heart disease were enrolled and divided into the statin group(n =40) and the control group (n =40).All patients were given conventional therapy,while the statin group received additionally rosuvastatin 10 mg/d for 6 months.The control group did not receive any lipid-lowering drugs.The plasma levels of hs-CRP,ET-1,NT-proBNP,liver and kidney functions and creatine kinase (CK),echocardiographic indicators of PASP and right ventricular ejection fraction (RVEF) were measured and compared before and after 6-month treatment.Results The levels of hs-CRP,ET-1,NT-proBNP and PASP were significantly lower after 6-month treatment than before treatment in the two groups (Statin group:hs-CRP:(7.45 ± 1.96) mg/L vs.(20.67 ± 5.12) mg/L,t =9.57,P ＜ 0.01 ; ET-1:(45.72 ± 6.85) ng/L vs.(56.39 ±7.34) ng/L,t =3.78,P ＜ 0.01 ; NT-proBNP:(136.54 ± 20.67) ng/L vs.(182.83 ± 23.27) ng/L,t =4.15,P ＜0.01 ;PASP:(42.6 ± 6.3)mm Hg vs.(52.3 ± 8.4) mm Hg,t =3.54,P ＜ 0.01 ; Control group:hs-CRP:(12.73 ±3.14) mg/L vs.(20.58 ±4.98)mg/L;t =4.96,P ＜0.01 ;ET-1:(51.66 ± 6.42)ng/L vs.(56.43 ±7.81) ng/L,t =3.43,P ＜ 0.01 ; NT-proBNP:(162.74 ± 21.59) ng/L vs.(181.56 ± 22.78) ng/L; t =3.60,P ＜0.01 ;PASP:(45.7 ±6.5) mm Hg vs.(51.8 ± 8.2) mm Hg,t =3.62,P ＜ 0.01),but the statin group reduced even more significantly (t =2.36,2.21,2.25 and 2.09 respectively,P ＜ 0.05).The level of RVEF was significantly higher after 6-month treatment than before treatment in the two groups (Statin group:(50.8 ±7.9) ％ vs.(41.5 ±6.7)％,t =3.69,P ＜0.01 ;Control group:(46.6 ±7.8)％ vs.(42.0 ±6.2)％,t =3.58,P ＜ 0.01),but the statin group increased even more significantly(t =2.18,P ＜ 0.05).Statistical differences of liver and kidney function and serum CK were not found in the two groups before and after treatment(P ＞ 0.05).The adverse reaction in the statin group was few.Conclusion Rosuvastatin can reduce the levels of hs-CRP,ET-1,NT-proBNP and PASP,improve RVEF and cardiac function in patients with chronic pulmonary heart disease,and its security is fine.
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Objective To explore the effect and mechanism of atorvastatin on pulmonary hyper-tension in chronic pulmonary heart disease.Methods Sixty eight patients with chronic pulmonary heart disease were randomly divided into treatment group (n=35) and observation group ( n=33 ).Thirty healthy people were picked up from people taking physical examination at the same stage as control group.Patients in both treatment and observation groups were given routine treatment and the observation group were given atorvastatin (20 mg/d) supplement.Changes in pulmonary function,ultrasound cardiogram,plasma high-sensitive C-reactive protein (hs-CRP) and interleukin (IL-8) were observed before and after 6 months of treatment.Results The levels of hs-CRP,IL-8 and pulmonary arterial pressure in treatment and observation groups are higher than that in normal group before treatment (t=2.87,2.79,3.01,3.28,3.31,3.15,respectively,and P =0.005,0.007,0.004,0.001,0.001,0.002,respectively).The pulmonary arterial pressure,hs-CRP,IL-8 in observation group after treated for 6 months were significantly lower than those before treatment and in treatment group (t=2.17,2.59,2.63,1.91,1.86,1.74,respectively,and P =0.039,0.008,0.007,0.031,0.037,0.042,respectively).The pulmonary function indexes including FEV1 and FEV1/FVC in observation group were much better than those in treatment group after 6 months treatment (t=1.84,2.13,respectively,and =0.037,0.024,respectively).There were no significant differences on these indicators in treatment group after 6 months treatment when compared with before treatment ( P ＞ 0.05 ).Conclusion Atorvastatin can effectively improve the life quality and pulmonary function,decrease pulmonary arterial pressure of patients with chronic pulmonary heart disease.These effects may be related to the inhibition of inflammation in pulmonary vessels.
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Objective To observe the therapeutic efficacy of combined use of"shen fu"injection(参附注射液),astragalus injecfion and tetramethylpyrazine injection in the treatment of heart failure due to chronic pulmonary heart disease.Methods 60 cases were randomly divided into a control guoup(n=28),which was treated with routine therapy and a treatment group(n=32),which was treated with"shen fu"injection,astmgalus injecdon and tetramethylpyrazine injection on basis of routinc therapy.Results The total effective rates were 93.8%and 53.6%in the treatment group and the control group respectively,demonstrating a obvious difference between the 2 groups(P＜0.01).The mortality is zero in the treatment group comparing with 17.9%in the control group.showing obvious difference between the 2 groups(P＜0.05).Conclusion Combined use of"shen fu"injection,astragalus injection and tetramethylpyrazine injection can decrease pulmonary artery pressure,improve cardiac performance and decrease mortality in the treatment of heart failure due to chronic pulmonary heart disease.
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OBJECTIVE To investigate the pathogenic change and bacterial antibiotic resistance in lower respiratory tract infection in inpatients of chronic pulmonary heavt disease(CPHD) for recently 3 years and to provide reference for clinical treatment.METHODS Retrospective analysis was conducted on sputum cultivation from CPHD patients who were hospitalized from Jan 2004 to Dec 2006.RESULTS A total of 772 pathogenic strains were isolated,60.1 % of which were Gram-negative bacilli.Pseudomonas aeruginosa,Klebsiella Pneumoniae,Escherichia coli and Acinetobacter baumannii were the main Gram-negative pathogens.Gram-positive bacilli accounted for 13.7%,most of which were Streptococcus pneumoniae,Staphylococcus aureus and so on.Fungi accounted for 26.2%.Imipenem/cilastatin sodium was the most sensitive drug for P.aeruginosa,Acinebacter and Enterobacteriaceae.And vancomycin hydrochloride was the most for S.aureus.Their multiple drug-resistance to anti-microbial agents was serious.CONCLUSIONS Gram-negative bacteria are the majority of the pathogens from CPHD of lower respiratory tract infection in hospital.The pathogens show multiple drug-resistance in drug sensitive test.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.
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Objective To investigate the effect of Brocho-Vaxom in curing chronic pulmonary heart disease and the influence of patient's immunity.Methods 58 patients with chronic pulmonary heart disease were randomly divided into two equal groups.Each patient of treatment group took a Brocho-Vaxom capsule(7mg/cap) every.The respiratory tract infection times and duration were observed.The serum IgA,IgG,IgM level were tested by fast immunonephelometry.The sub-type lymphocyte was tested by SP,and the NK cell's activity was tested by MTT.Results The infection time obviously declined in treatment group which the average was (2.5?1.8) in five months as compared with that in the controlled group(P
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[Objective]To explore the therapeutic effect of Shenmai injection on hemorheology and arterial blood gas in patients with chronic pulmonary heart disease.[Methods]Eighty patients with chronic pulmonary heart disease were randomly divided into two groups: Shengmai group and control group.Determine blood viscosity,hematocrit,arterial blood gas and length of stay in two groups before and after the treatment respectively.[Results]Blood viscosity,hematocrit,arterial blood gas and length of stay in Shengmai group were markedly improved compared with that in control group.[Conclusion]Shengmai Injection could promote patients with chronic pulmonary heart disease recovery by improving blood viscosity and arterial blood gas.