目的:分析乌司他丁对慢性心力衰竭(CHF)患者的治疗效果及其对血浆神经内分泌因子水平的影响.方法:选取CHF患者78例,随机分为观察组及对照组,两组均给予常规抗心衰治疗,观察组在常规治疗的基础上联合乌司他丁注射液治疗,连续治疗7 d;检测治疗前后两组血清炎性因子、血浆神经内分泌因子水平及T淋巴细胞亚群的变化;分别于治疗前后行超声心动图检测,比较两组心功能指标变化.结果:两组治疗后血清CRP、IL-6、TNF-α及观察组血浆BNP、ANP、ET及β2-MG与治疗前比较均显著降低,且观察组显著低于对照组(P<0.05);观察组治疗后IL-10显著升高,且显著高于对照组(P<0.05);治疗后两组LVESD、LVEDD与治疗前比较明显减小,而LVEF明显增大(P<0.05);观察组治疗后LVEF显著高于对照组(P<0.05);治疗后两组CD3+与治疗前比较无显著变化(P>0.05),而CD4+明显升高,CD8+明显降低,且两组间差异显著(P<0.05);观察组治疗后CD4+/CD8+明显升高且显著高于对照组(P<0.05).结论:在常规治疗的基础上联合乌司他丁注射液可抑制CHF患者神经内分泌因子过度活化,提高其细胞免疫功能,减轻炎性反应,促进心功能恢复,疗效显著.%Objective: To analyze the therapeutic effect of ulinastatin in the treatment of chronic heart failure (CHF) and the effect on the plasma neuroendocrine factor.Methods: A total of 78 patients with CHF who were admitted in our hospital were included in the study and randomized into the observation group and the control group.The patients in the two groups were given routine anti-heart-failure treatments.On this basis, the patients in the observation group were given ulinastatin injection, continuously for 7 d.The serum inflammatory cytokines, plasma neuroendocrine factors, and T lymphocyte subsets before and after treatment in the two groups were detected.Echocardiography was performed before and after treatment.The cardiac function indicators in the two groups were compared.Results: The serum CRP, IL-6, and TNF-α, and plasma BNP, ANP, ET, and β2-MG after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05).IL-10 after treatment in the observation group was significantly higher than that in the control group (P<0.05).LVESD and LVEDD after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05), while LVEF was significantly increased (P<0.05).LVEF after treatment in the observation group was significantly higher than that in the control group (P<0.05).CD3+ after treatment in the two groups was not significantly changed when compared with before treatment (P>0.05), while CD4+ was significantly elevated (P<0.05), and CD8+ was significantly reduced (P<0.05), and the comparison between the two groups was statistically significant (P<0.05).CD4+/CD8+ after treatment in the observation group were significantly higher than that in the control group (P<0.05).Conclusions: Routine treatment in combined with ulinastatin injection can significantly inhibit the excessive activation of neuroendocrine factors in patients with CHF, enhance the cellular immune function, alleviate the inflammatory reaction, and promote the recovery of cardiac function, with a significant efficacy.
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