重组人脑钠肽对扩张型心肌病及心肌梗死所致急性心力衰竭的疗效分析

Curative Effect Analysis of Recombinant Human Brain Natriuretic Peptide on Acute Heart Failure Induced by Dilated Cardiomyopathy and Myocardial Infarction

目的探究重组人脑钠肽(rhBNP)对扩张型心肌病及心肌梗死所致急性心力衰竭的治疗效果。方法选取2007年4月至2011年8月兰州军区乌鲁木齐总医院收治的扩张型心肌病及心肌梗死致急性心力衰竭患者136例,采用区组随机分组法分为观察组和对照组各64例,在常规治疗的基础上分别使用rhBNP和硝普钠进行治疗,观察治疗前后两组患者的症状、血清脑钠肽水平及心室功能改善情况。结果观察组治疗总有效率97.1%,无恶化患者;对照组总有效率76.5%,出现2例恶化患者均死亡。两组患者治疗后血清脑钠肽水平、左心室舒张末期内径和左心室射血分数均有一定程度的改善,观察组改善情况显著优于对照组,两组总有效率比较差异有统计学意义(P<0.05)。观察组患者出院后出现2例低血压,随访中发现6例心源性死亡;对照组出现8例低血压,随访中发现4例心源性死亡,两组患者均未出现肝肾功能异常、栓塞等不良反应。观察组出现并发症的例数显著少于对照组,但两组的心源性死亡例数比较差异无统计学意义。结论 rhBNP治疗扩张型心肌病及心肌梗死所致急性心力衰竭具有良好的疗效及安全性,值得临床推广。

Objective To explore the recombinant human brain natriuretic peptide on acute heart failure induced by dilated cardiomyopathy and myocardial infarction.Methods From Lanzhou General Hospital of Urumqi Military Command during April 2007-August 2011,136 cases of acute heart failure caused by dilated cardiomyopathy and myocardial infarction were selected and randomly divided into the observation group and control group of 64 cases each,based on the conventional therapy recombinant human brain natriuretic peptide（rhBNP） and sodium nitroprusside（NIP） treatment was used,symptoms,serum BNP content and ventricular function of the two groups before and after treatment were observed.Results The total effective rate of the observation group was 97.1%,no deterioration of the patient;the total effective rate of the control group was 76.5%,2 cases died of deterioration.Sserum BNP,LVEDd and LVEF of the two groups after treatment were improved to a certain extent,and the improvement of the observation group was better than that of the control group,the difference of total effective rate between the two groups was statistically significant（P 0.05）;hypotension in 2 patients,6 cases of cardiac death occurred in the observation group;8 cases of hypotension and 8 cases of cardiac death occurred in the control group;there were no adverse reactions such as liver and kidney dysfunction embolization in both groups.Complications in the observation group was significantly less than that in the control group,while the cardiac death number of the two groups had no statistically significant difference.Conclusion Recombinant human brain natriuretic peptide as the treatment of dilated cardiomyopathy and myocardial infarction induced acute heart failure has good efficacy and safety,which is worthy of clinical application.