摘要:目的:观察伴有抑郁症状的心力衰竭患者加用黛力新干预的疗效。方法: 65例用Zung抑郁自评量表检测评测诊断为抑郁症并心力衰竭患者,将患者分为黛力新治疗组及对照组,治疗组在常规治疗基础上加用黛力新(2片/d),治疗1个月后再行Zung抑郁自评量表粗分及24项症状统计,同时观察治疗前后患者心功能改善情况。结果: 35例治疗组患者心功能的改善及Zung抑郁自评量表检测粗分及24项症状改善明显优于对照组。〖HTH〗结论〖HTSS〗: 黛力新使心衰患者的抑郁症状很快得到改善,并提高了心力衰竭的疗效。Abstract: Objective: To observe the curative efficacy of deanxit to the patients suffering by heart failure with depression. Methods: Sixtyfive patients who were diagnosed as depression by Zung Selfrating Depression Scale are into deanxit treatment group and control group,and treatment group receive the treatment with two pieces of deanxit everyday besides the conventional therapy.After a month,we count the Zung selfrating depression scale score and study the24 symptoms,at the same time,we observed the change of cardiac function in the patients. Results:The curative efficacy in the treatment group is better than those in the control group with improvement in cardiac function and Zung selfrating depression scale score and the alleviation for 24 symptoms. Conclusion:Deanxit can alleviate symptoms of depression in patients with heart failure soon and increase the efficacy of heart failure.
ObjectiveTo overview of systematic reviews (SRs) of Yiqi Fumai (YQFM) injection in the treatment of chronic heart failure (CHF). MethodsThe PubMed, Cochrane Library, EMbase, Web of Science, CNKI, CBM and WanFang Data databases were electronically searched to collect SRs of YQFM injection in the treatment of CHF from January 1, 2007 to October 31, 2022. Two reviewers independently screened literature, extracted data and assessed methodological quality, risk of bias, report quality and evidence quality by using AMSTAR-2, ROBIS scale, PRISMA, and GRADE system. ResultsA total of 7 SRs were included. The evaluation results showed that the quality of all SRs was low, a few SRs were assessed as having a low risk of bias, and all SRs were relatively completely reported. A total of 46 results were extracted from the included SRs, including 3 with moderate quality evidence, 12 with low quality evidence and 31 with very low quality evidence. ConclusionYQFM may be an effective and safe treatment, but current evidence quality is low.
慢性心力衰竭发生率和死亡率均较高，夜间睡眠中反复发生的呼吸暂停和缺氧是促进心力衰竭恶化的因素之一。中枢性睡眠呼吸暂停（central sleep apnea ,CSA）为起源于脑干呼吸控制中枢障碍的呼吸暂停，表现为呼吸减弱或停止。在普通人群中CSA患病率很低，但在慢性心力衰竭患者中则很高，且常常以陈-施呼吸（Cheyne-Stokes respiration，CSR），即CSR-CSA形式出现。CSA可进一步加重心力衰竭，因此越来越受到重视[1]。
【摘要】 目的 观察慢性心力衰竭营养支持治疗的疗效。 方法 将2007年1月〖CD3/5〗2009年10月期间收治的56例慢性心力衰竭住院患者随机分为常规治疗组及强化营养支持治疗组,每组28例患者。其中,强化治疗组是在常规治疗的基础上,给与强化营养支持治疗。比较两组治疗前后6 min步行距离、NYHA心功能评级及射血分数。 结果 治疗后,患者6 min步行距离、心功能评级强化营养治疗组优于常规治疗组。左心室射血分数两组无差异。 结论 对慢性心力衰竭患者,营养支持治疗是重要的治疗手段。【Abstract】 Objective To study the efficacy of nutritional support treatment for chronic heart failure. Methods 56 patients with chronic heart failure hospitalized patients were randomly divided into conventional therapy group and enhanced nutritional support therapy group, 28 patients in each group. Where enhenced therapy group is on the basis of conventional therapy to give extra enhanced intensive nutrition support treatment. Before and after treatment were compared sixminutes walking distance, NYHA cardiac function class, ejection fraction, mortality. Results After treatment, patients with sixminutes walking distance, cardiac function class,enhanced nutritional support therapy group is better than conventional treatment group. Left ventricular ejection fraction was no difference. Conclusion Patients with chronic heart failure, nutritional support treatment is an important treatment.
ObjectiveTo investigate the role of mindfulness-based stress reduction in improving anxiety and depression in elderly patients with chronic heart failure.MethodsFrom August 2016 to August 2018, a total of 196 elderly patients with chronic heart failure were randomly divided into the treatment group and the control group, with 98 cases in each group. The control group received routine care. The treatment group received routine care plus mindfulness-based stress reduction in two 60-minute sessions a week for 8 weeks. The level of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected by electrochemiluminescence immunoassay, and left ventricular ejection fraction (LVEF) was measured by echocardiography before intervention and at week 8 of intervention; the effective rate was calculated. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and General Well-Being scale (GWB) were used to assess the degree of anxiety, depression, and well-being of patients before intervention and at week 8 of intervention.ResultsThe serum NT-proBNP levels at week 8 of intervention in the two groups were lower than those before intervention, and the LVEFs were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05). The effective rate of the treatment group was higher than that of the control group (89.80% vs. 69.39%, P<0.05). Before intervention, the SAS scores in the treatment group and the control group were 56.61±8.25 and 55.98±6.32, respectively, the SDS scores were 59.98±7.21 and 58.86±6.17, respectively, and the GWB scores were 53.19±12.38 and 54.06±10.93, respectively; at week 8 of intervention, the SAS scores in the treatment group and the control group were 40.56±8.17 and 46.25±5.43, respectively, the SDS scores were 42.85±5.77 and 48.34±8.01, respectively, and the GWB scores were 76.17±9.63 and 68.58±13.30, respectively. At week 8 of intervention, the SAS and SDS scores of the two groups were both lower than those before intervention, and the GWB scores were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05).ConclusionMindfulness-based stress reduction can improve the anxiety and depression of elderly patients with chronic heart failure, improve their well-being and promote the recovery of heart function.
ObjectivesTo analyze the application value of 6-minute walking test (6MWT) in the clinical evaluation of chronic heart failure (CHF).MethodsPubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were searched online to collect randomized controlled trials (RCTs) of 6-minute walking distance (6MWD) as the CHF evaluation index. Two reviewers independently screened literature, extracted data, and then analyzed data by using SPSS 17.0 statistical software. The 6MWD with symptom, quality of life, exercise tolerance (ETT), left ventricular ejection fraction (LVEF), peak oxygen consumption (pVO2) were analyzed by Kappa consistency test, and the possible influencing factors of 6MWD were analyzed by logistic regression.ResultsA total of 158 RCTs involving 17 853 patients were included. The results of statistical analysis showed that: 6MWD was consistent with the improvement of symptoms, quality of life, ETT, LVEF and pVO2 (Kappa>0.4). Baseline 6MWD (OR=2.91, 95%CI 1.278 to 6.634,P=0.011) and NYHA Ⅲ-Ⅳ ratio (OR=2.59, 95%CI 1.091 to 6.138, P=0.031) were the independent influencing factors for 6MWD improvement separately.ConclusionsThe 6MWT is an objective and reliable indicator of CHF evaluation.
摘要:目的：探讨β受体阻滞剂在慢性心力衰竭急性失代偿情况下的正确应用。方法：对我院2005年1月～2006年12月收治的104例确诊慢性心力衰竭急性失代偿并使用β受体阻滞剂患者的治疗措施及预后转归进行回顾性分析。结果：104例患者男性61例，女性43例，平均年龄64.4±17.5岁，其中45～70岁占6792。好转占85%，死亡占10%，建议外出心脏移植5%。停止使用β受体阻滞剂的19人中17人重新恢复了使用，减量的65人中，59人的β受体阻滞剂重新加量至入院前的水平。结论：慢性心力衰竭在急性失代偿期合理使用β受体阻滞剂对患者预后有重要意义。心力衰竭急性失代偿控制后，β受体阻滞剂应恢复使用并逐渐增量至一个合理的剂量长期使用。
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.
The fundamental reason why the organic lesions of chronic heart failure are difficult to reverse is ventricular remodeling. Myocardial fibrosis (MF) is an important pathological basis of ventricular remodeling. Its development process involves complex biological mechanisms and neuroendocrine system. Extracellular signal-regulated kinase (ERK) pathway is a classic pathway for the treatment of tumors. It is found that the inhibition of the ERK pathway can also slow down the progressive aggravation of MF. Therefore, exploring the mechanism of ERK pathway in MF may provide a new idea for the prevention and treatment of chronic heart failure. In this paper, the mechanism of ERK pathway in the occurrence and development of MF and its inhibition drugs were described, in order to provide evidence for the prevention and treatment of MF in chronic heart failure based on this pathway.
ObjectivesTo systematically review the efficacy and safety of ivabradine (IVA) for patients with chronic heart failure (CHF).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of IVA for patients with CHF from inception to April, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed using Stata 12.0 software.ResultsA total of 22 RCTs involving 2 010 patients were included. The results of meta-analysis showed that, compared with control group, IVA group could decrease heart rate (HR) (WMD=−10.58, 95%CI −12.47 to −8.69, P=0.000) and N-terminal probrain natriuretic peptide (NT-proBNP) (WMD=−457.87, 95%CI −842.63 to −73.11, P=0.020). IVA group was superior in 6 minutes’ walk distance (6MWD) (WMD=40.49, 95%CI 27.83 to 53.15, P=0.000), left ventricular ejection fraction (LVEF) (WMD=5.11, 95%CI 3.74 to 6.48, P=0.000), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic dimension (LVESd) and incidence of endpoint events with significant difference. However, the total effective rate, the incidence of adverse reactions and blood pressures were similar between two groups.ConclusionCurrent evidence shows that IVA could significantly reduce HR, improve cardiac function and exercise tolerance in CHF patients with no significant increase of adverse events. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.