重组人脑利钠肽治疗急性非ST段抬高型心肌梗死并发心力衰竭临床观察

Clinical observation of recombinant human brain natriuretic peptide in the treatment of acute non-ST-seg- ment elevation myocardial infarction patients with heart failure

目的观察重组人脑利钠肽（rhBNP）治疗急性非ST段抬高型心肌梗死（NSTEMI）并发心力衰竭的疗效和安全性。方法选取80例NSTEMI并发心力衰竭患者，根据随机数字表法分为观察组和对照组，每组各40例。观察组给予静脉注射rhBNP治疗，对照组静脉注射硝酸甘油。比较两组用药前后生命体征、呼吸困难程度、脑钠肽（BNP）、相关血流动力学指标的变化及不良反应。结果观察组治疗总有效率87．5％（35／40），高于对照组的50．0％（20／40）（χ2=13．09，P〈0．05）。观察组治疗后左室射血分数（LVEF）和每小时平均尿量均较治疗前显著升高（t=26．40、3．22，均P〈0．05），BNP水平较治疗前显著降低（t=14．11，P〈0．05）。而对照组治疗前后LVEF、BNP和尿量均无明显变化。结论rhBNP治疗NSTEMI并发心力衰竭疗效显著，副作用少，具有较高的临床应用价值。

Objective To investigate the the efficacy and safety of recombinant human brain natriuretic pep- tide （rhBNP） in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure. Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were cho- sen,they were divided into the observation group and control group based on a random number table, each group included 40 patients . The observation group were treated with intravenous injection of recombinant human brainnatriuretic peptide, the control group were treated with intravenous nitroglycerin, vital signs, dyspnea, brain natriuretic peptide （BNP） ,associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment. Results The total effective rate in observation group was 87.5% （35/40） ,which were significantly higher than 50.0% （20/40）of the control group, there were significant difference （χ2 = 13.09, P 〈 0.05 ）. In the observation group, after treatment, the left ventricular ejection fraction （LVEF） and average hourly urine output were significantly higher than those of before treatment （ t = 26.40,3.22, all P 〈 0. 05 ）, and the brain natriuretic peptide （BNP） con- centration levels were significantly lower than those of before treatment （ t = 14.11, all P 〈0. 05 ）. The control group before and after treatment LVEF, BNP and changes in urine levels were not significantly. Conclusion In the treat- ment of heart failure caused by acute non-ST-segment elevation myocardial infarction, the recombinant human brain natriuretic peptide （rhBNP） has significant effect,feasible and safe with few side effects,which has a high clinical value.