Effects Of Shengmai Injection With Atorvastatin On Oxdative Stress And Ventricular Remodeling In Patients With Chronicheart Failure

[Objective]:To study the effects of Shengmai injection with Atorvastatin on Oxdative Stress and Ventricular Remodeling in patients with Chronic Heart Failure and To study It's mechanism.[Meththods]:To choose 60 Patients with Chronic Heart Failure on the department of cardiology of Yanbian University hospital since may 2007 to march 2008.60 Patients have been made a definite diagnosis The Chronic Heart Failur(New York Heart Association NYHA functional classⅣ)。On the basis of clinical symptom,physical sign,electrocardiogram,echocardiogram.the 60 Patients are divided into control group and The experimental group randomly,The control group of 30 patients(16 men,14 women) which,14 cases of coronary heart disease,Hypertensive heart disease 8cases, the dilated cardiomyopathy 8 cases,the age of 47 to 81-year-old,the average(65±8) years of age.Experimental group of 30 patients(16 men,14 women) which,17 cases of coronary heart disease,Hypertensive heart disease 10 cases,dilated cardiomyopathy 3 cases;aged 46-82 years old,on average(65±7) years of age.Two groups of patients are treated and control the increasing incidence of factors.The control group using conventional triple therapy:ACEI,diuretics,digitalis preparations. The experimental group in the control group on the basis of the treatment,plus Shengmai injection in 40 ml and 5%glucose 250 ml(1 time / day) with Atorvastatin 10 mg(1 time / day) for 15 days for observation of clinical efficacy and cardiac function Improve the situation.Detection of serum Superoxide dismutase(SOD), malondildehyde(MDA ),Matrix metalloproteases-9(MMP-9) content,and Left ventricular ejection fraction(LVEF) changes.Clinical judgement:markedly effective: symptoms,heart function improvedⅡ;effective:to reduce symptoms,improve heart function LevelⅠ;invalid:symptoms,improve heart function without.NYHA classification of cardiac function according to exclude acute and chronic infectious diseases,diabetes,acute cardiac insufficiency,the recent unstable angina and acute myocardial infarction(three months),serious liver and kidney dysfunction, autoimmune diseases,cancer,Chronic respiratory disease,three months have rheumatoid impact of immunization activities and the use of drug activities.[Results]1.Two main symptoms and signs to improve the situation:After treatment with chest tightness,shortness of breath,fatigue,and pulmonary edema at the end of the Romanian-patients,the experimental group were 24(80%),23(77.7%),25 (83.3%),24(80%) were significantly improved.The control group were 16(53.3%), 14(46.7%),17(56.7%),16(53.3%) cases improved,the significant difference between the two groups(P＜0.05).2.Clinical compared two groups:the experimental group markedly effective in 16 cases,12 cases of effective and ineffective two cases, the total efficiency of 93.3 percent.Eight cases markedly effective control group, effective in 15 cases,seven cases invalid,and the total efficiency of 76.7 percent, significantly(P＜0.05).3.LVEF of the two groups before and after treatment:the experimental group and control group were treated before LVEF(32.9±6.7%,33±5.2%),there was no significant difference(P＞0.05);LVEF after treatment, respectively(43.7±5.9%,39.2±6.3%),significantly(P＜0.05).The experimental group in patients with MMP-9,MDA and the concentration of SOD activity:before treatment[(120.32±28.3ng/ml)(7.1±2.3μmol / ml)(59.8±19.2u/ml)]after treatment:[(70.25±20.78 ng/ml)(5.5±1.6μmol / ml)(87.2±19.1u/ml)]in the control group patients with MMP-9,MDA and the concentration of SOD activity: before treatment[(114.76±24.43ng/ml)(7.0±2.0μmol / ml)(60.3±17.5u/ml)] after treatment[(90.23±32.16 ng / ml),(6.2±1.5μmol / ml)(85±17.2u/ml)]the two groups before treatment No difference,after treatment P＜0.05 MMP-9,MDA concentration was significantly lower,SOD activity increased,LVEF and MMP-9, MDA concentration level was negatively correlated(r =-0.78,r =-0.741,) and SOD activity was positively correlated(r = 0.723). [Side effects]:liver and kidney function before and after treatment groups,urine routine,not found any adverse reaction.[Conclusion]1.Based on conventional triple combination Shengmai injection and atorvastatin to patients with heart failure clinical symptoms and signs of strong effect on the efficacy of conventional triple basis.2.Based on conventional triple combination Shengmai injection and atorvastatin to patients with heart failure LVEF strong improvement in the conventional triple therapy.3.LVEF patients with congestive heart failure and serum SOD activity was negatively correlated;LVEF and MDA,MMP-9 in concentration was positively correlated.4.Based on conventional triple combination Shengmai injection and atorvastatin and conventional triple therapy could be better compared to the body by reducing the free-base occurred in removing free radicals and enhance antioxidant enzyme activity to reduce Stress levels in patients with heart failure,and by blocking the formation MMP-9 in the prevention of further ventricular remodeling,with no apparent side effects less.