[摘要]目的探讨中药黄芪精口服液对围生期心肌病患者心功能不全及辅助T细胞的调节作用。方法36例围生期心肌病住院患者随机分为常规治疗对照组与加用黄芪精口服液治疗组,治疗8周后应用超声心动图观察患者心功能,检测心功能不全实验室相关指标N末端脑钠肽前体(NT—proBNP)及免疫相关指标IFN-γ、IL-2、IL-4、IL-10并进行疗效的比较。结果治疗8周后2组心率、左室收缩末内径和左室舒张末内径均较治疗前显著减小(P均〈0.05),左室射血分数、左室短轴缩短率、每搏量和心排血量较治疗前显著提高(P均〈0.05),以上各项指标治疗组均较对照组改善明显(P均〈0.05);NT-proBNP在治疗8周后2组皆有显著下降,治疗组下降更显著(P〈0.05);血清IFN-γ和IL-2明显降低,IL-4和IL-10水平明显升高。结论黄芪精口服液配合常规治疗围生期心肌病患者可以显著改善心功能,提高治疗效果,并使辅助T细胞的平衡从Th1向Th2移动。
Objective It is to observe the effect of Huangqijing oral solution on cardiac dysfunction and the regulatory of helper T cell in patients with peripartum cardiomyopathy. Methods 36 cases of peripartum cardiomyopathy patients were ran- domly divided into the control group treated with normal therapy and the treatment group treated with Huangqijing oral solution additionally. Heart function was detected by echocardiography, the levels of NT - proBNP and immune indicators such as IFN-γ, IL-2, IL-4 and IL- 10 were measured after 8 weeks' treatment, and the curative effect was compared between the two groups. Results After 8 weeks treatment, heart rate (HR) , left ventricular end systolic diameter (LVDs) and left ventricular end diastolic diameter (LVDd) were significantly decreased in treatment group comparing with the control group (P 〈 O. 05 ). Left ventrieular ejection fraction (LVEF) , left ventricular fractional shortening ((FS) , stroke volume (SV) and car- diac output (CO) were significantly increased ( P 〈 0.05 ) in treatment group after 8 weeks. All the above indicators in the treatment group were improved more significantly than that of the control group ( P 〈 0.05 ). The level of NT - proBNP was significantly decreased after 8 weeks' treatment in both groups, the decrease was more obviously in treatment group than that in control group. Compared with the control group, the concentration of cytokines IFN-γ and IL - 2 were significantly lower after treatment, but in the treatment group was more significant (P 〈 0.05 ). In addition, the serum level of Th2 cytokines IL - 4 and IL - 10 were significant up-regulated after 8 weeks' treatment( P 〈 0.05 ). Conclusion Huangqijing oral solution com- bined with conventional treatment of peripartum cardiomyopathy can significantly improve heart function, improve the treatment effect, and let T helper cell balance moves from Thl to Th2.