重组人脑利钠肽对急性心肌梗死伴心力衰竭患者心功能及心室重构的影响

Effects of recombinant human brain natriuretic peptide on cardiac function and ventricular remodeling in acute myocardial infarction patients with heart failure

目的探讨重组人脑利钠肽(rhBNP)治疗急性心肌梗死(AMI)伴心力衰竭的疗效,及其对心功能、心室重构的影响。方法选择2013年1月—2015年1月收治的AMI伴心力衰竭患者86例,根据随机数字表将其分为2组,每组43例。观察组在冠状动脉支架植入后静脉注射rhBNP治疗,对照组静脉泵入硝普钠或硝酸甘油。观察2组治疗效果、治疗前后心功能变化及患者心室重构情况。结果观察组治疗总有效率为86.05%,高于对照组的65.12%(x^2=5.235,P<0.05);与治疗前比较,2组治疗后左室内径缩短率(LVFS)、左室射血分数(LVEF)显著升高(P均<0.05),左室舒张末期内径(LVEDD)、舒张时间(IVRT)、左室后壁厚度(LVPWT)、间隔厚度(IVST)、左室质量指数(LVMI)等左心室重构指标显著降低(P均<0.05),且治疗后观察组以上各指标均优于对照组(P<0.05)。结论rhBNP治疗AMI伴心力衰竭疗效显著,可以有效提高患者的心功能状况,抑制心室重构,适于临床推广。

Objective To investigate the effect of recombinant human brain natriuretic peptide （ rhBNP） in treatment of acute myocardial infarction （AMI） patients with heart failure, and its effect on cardiac function, ventricular remodeling. Methods From January 2013 to January 2015, 86 patients with heart failure were divided into 2 groups according to the ran-dom number table , 43 cases in each group .In the observation group , after coronary stent implantation , rhBNP intravenous in-jection was performed , control group with intravenous infusion of sodium nitroprusside and nitroglycerin .Observed the thera-peutic effect of the 2 groups , the change of heart function and ventricular remodeling after treatment .Results In the observa-tion group, the total efficiency was 86.05%, which was higher than that of the control group ’s 65.12%（χ2 =5.235, P 〈0.05）, and compared with before treatment , 2 groups after the treatment ’s left ventricular diameter shortening ratio （LVFS）, left ventricular ejection fraction （LVEF） were significantly increased （ P 〈0.05）, left ventricular end diastolic diameter （LVEDD）, relaxation time （IVRT）, left ventricular posterior wall thickness （LVPWT） and septal thickness （IVST）, left ventricular mass index（LVMI） and left ventricular remodeling index was significantly reduced （ P 〈0.05）, and in the treat-ment group, these indexes were better than in the control group （ P 〈0.05）.Conclusion It demonstrated that the rhBNP for treatment of AMI with heart failure was effective , it could effectively improve the patient＇s heart function , inhibit ventricular re-modeling , which is suitable for clinical promotion .