冻干重组人脑利钠肽联合左西孟旦治疗心功能Ⅲ~Ⅳ级的慢性心力衰竭急性发作患者临床研究

Clinical Study on Freeze-dried Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan in Patients with Acute Attack of Chronic Heart Failure with Cardiac Function of Grade Ⅲ~Ⅳ

目的:探讨左西孟旦联用冻干重组人脑利钠肽治疗心功能Ⅲ~Ⅳ级慢性心力衰竭(CHF)急性发作期的价值。方法:按照随机数字表法将我院2017年1月—2018年11月收治的138例心功能Ⅲ~Ⅳ级CHF急性发作患者分为观察组与对照组,各69例。常规治疗及干预基础上,对照组给予左西孟旦治疗,观察组给予左西孟旦+冻干重组人脑利钠肽治疗,于治疗7 d后评价相关指标。比较两组临床疗效、心功能指标[左室射血分数(LVEF)]改善情况及治疗期间不良反应发生率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗7 d后两组LVEF较治疗前增加,且观察组高于对照组,差异有统计系意义(P<0.05);两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:左西孟旦基础上给予心功能Ⅲ~Ⅳ级CHF急性发作患者冻干重组人脑利钠肽治疗的效果显著,可有效改善患者心功能,且安全性较好。

Objective:To explore the value of levosimendan combined with freeze-dried recombinant human brain natriuretic peptide in the treatment of acute attack of chronic heart failure(CHF)with cardiac function of gradeⅢ~Ⅳ.Methods:138 patients with acute attack of CHF with cardiac function of gradeⅢ~Ⅳadmitted to our hospital from January 2017 to November 2018 were randomly divided into an observation group and a control group,69 cases each.On the basis of conventional treatment and intervention,the patients in the control group were treated with levosimendan,and the patients in the observation group were treated with levosimendan and freezedried recombinant human brain natriuretic peptide.The relevant indexes were evaluated after 7 days of treatment.The clinical efficacy,the improvement of cardiac function index[left ventricular ejection fraction(LVEF)]and the incidence of adverse reactions during treatment were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The LVEF after 7 days of treatment increased compared with that before the treatment in the two groups,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Freeze-dried recombinant human brain natriuretic peptide based on levosimendan has a significant effect in the treatment of acute attack of CHF with cardiac function of gradeⅢ~Ⅳ,which can effectively improve the cardiac functions of the patients,and has better safety.