新活素对心肌梗死泵功能衰竭患者心肌重构的影响研究

Effect of Natriuretic Peptide on Myocardial Remodeling of Patients with Pump Failure Complicating Myocardial Infarction

目的观察重组人脑利钠肽(新活素)对心肌梗死泵功能衰竭患者心肌重构的影响。方法将118例心肌梗死泵功能衰竭患者按照随机数字法分为观察组及对照组各59例,对照组给予传统治疗,观察组在对照组治疗基础上加用新活素静脉滴注治疗3 d,观察两组患者治疗前、治疗后1、3、12月时的左室射血分数(LVEF)、左室舒张末期容积(LV-EDV)、左室收缩末期容积(LVESV)及主要不良心脏事件(MACE)发生情况。结果治疗前两组LVEF、LVEDV、LVESV差异无统计学意义(P>0.05);治疗后1、3、12个月时两组间LVEF、LVEDV、LVESV差异均有统计学意义(P<0.05);1、3个月时MACE发生率差异无统计学意义(P>0.05),12个月时发生率差异有统计学意义(P<0.05)。结论心肌梗死合并心力衰竭患者在早期使用新活素治疗可以明显改善心肌供血,观察近期治疗疗效新活素对心肌重塑有明显抑制作用。

Objective To observe the influence of lyophiluzed recombinant human brain natriuretic peptide on myocardial remodeling of patients with pump failure complicated by myocardial infarction. Methods With random number method, 118 patients with pump failure complicated by myocardial infarction were divided into observation group and control group （each n = 59）. The patients in control group were given traditional treatment. In addition to routine therapy of the control group, the pa- tients in observation group were treated with natriuretic peptide by intravenous infusion for 3 days. We observed and compared left ventricular ejection fraction （LVEF）, left ventricular end- diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV） and major adverse cardiac events （MACE） of the two groups before the treatment, 1 month, 3 - month and 12 - month after the treatment. Results Before the treatment, no statistically significant difference was found in LVEF, LVEDV and LVESV between the two groups （P〉O. 05）. After 1 - month, 3 - month and 12 - month treatment, there were statistical- ly significant differences in LVEF, LVEDV and LVESV between the two groups （P〈 0.05）. No statistically significant differ- ence was found in the incidence of MACE after 1 month and 3 - month treatment （ P 〉 0.05 ）, while there were statistically significant differences in the incidence after 12- month treatment （P 〈 0.05）. Conclusions Adopting natriuretic peptide in the early period can significantly improve the myocardium blood supply of patients with myocardial infarction complicated by heart failure, and effectively inhibit the myocardial remodeling according to the potency of short-term observation.