重组人脑利钠肽联合脑心通胶囊治疗急性心力衰竭的临床疗效观察

Clinical Effect of Recombinant Human Brain Natriuretic Peptide Combined with Naoxintong Capsule on Acute Heart Failure

目的观察重组人脑利钠肽联合脑心通胶囊治疗急性心力衰竭(AHF)的疗效。方法选取儋州市第一人民医院心血管内科2013年5月—2015年5月收治的AHF患者152例,按照随机数字表法分为对照组和试验组,每组76例。两组患者均在常规治疗的基础上给予重组人脑利钠肽0.5 mg+0.9%氯化钠溶液50 ml,静脉滴注,试验组患者在此基础上加用脑心通胶囊口服治疗;两组患者均持续治疗3 d。比较两组患者临床疗效、住院时间、临床转归,治疗前及治疗3 d后舒张压(DBP)、收缩压(SBP)、平均动脉压(MAP)、心率(HR)、脑利钠肽前体(NT-pro BNP)、醛固酮、血肌酐清除率(Ccr)、血钾、血钠和尿量,记录两组患者不良反应发生情况、出院30 d再住院率及病死率。结果试验组患者临床疗效及临床转归优于对照组(P<0.05)。两组患者住院时间比较,差异无统计学意义(P>0.05)。治疗前,两组患者DBP、SBP、MAP、HR、NT-pro BNP、醛固酮比较,差异无统计学意义(P>0.05);治疗3 d后,试验组患者DBP、SBP、MAP、HR、NT-pro BNP、醛固酮均低于对照组(P<0.05)。两组患者治疗前及治疗3 d后Ccr、血钾、血钠及尿量比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。试验组患者出院30 d再住院率低于对照组(P<0.05)。两组患者出院30 d病死率比较,差异无统计学意义(P>0.05)。结论重组人脑利钠肽联合脑心通胶囊可有效改善AHF患者临床症状及预后,临床疗效确切且安全性良好。

Objective To observe the clinical effect of recombinant human brain natriuretic peptide combined withnaoxintong capsule on acute heart failure. Methods From May 2013 to May 2015, a total of 152 patients with acute heartfailure were selected in the Department of Cardiovascular Medicine, the First People＇s Hospital of Danzhou, and they weredivided into control group and experiment group according to random number table, each of 76 cases. Based on conventionaltreatment, patients of the two groups received intravenous drip of recombinant human brain natriuretic peptide （ 0 .5 mg）combined with 0. 9% sodium chloride solution （5 0 m l） , while patients of experiment group received extra oral naoxintongcapsule; both groups continuously treated for 3 days. Clinical effect, clinical outcome and hospital stays, DBP, SBP, MAP,HR, NT-proBNP, aldosterone, Ccr, serum kalium, serum sodium and urine volume before treatment and after 3 days oftreatment were compared between the two groups, incidence of adverse reactions, rehospitalization rate and fatality rate after 30days of hospital discharge were recorded. Results Clinical effect and clinical outcome of experiment group were statisticallysignificantly better than those of control group （ P 〈 0. 05 ） , while no statistically significant differences of hospital stays wasfound between the two groups （ P 〉 0. 05 ） . No statistically significant differences of DBP, SBP, MAP, HR, NT-proBNP oraldosterone was found between the two groups before treatment （ P 〉 0. 05） , while DBP, SBP, MAP, HR, NT-proBNP andaldosterone of experiment group were statistically significantly lower than those of control group after 3 days of treatment （ P 〈0. 0 5 ）. No statistically significant differences of Ccr, serum kalium, serum sodium or urine volume was found between the two groups before treatment or after 3 days of treatment （P 〉0. 0 5 ） , nor was incidence of adverse reactions between the two groups（ P 〉 0. 05 ） . The rehospitalization rate of experiment group was statistically significantly lower than that of control group after 30days of hospital discharge （ P 〈 0. 05 ） , while no statistically significant differences of fatality rate was found between the twogroups after 30 days of hospital discharge （ P 〉 0. 05 ）. Conclusion Recombinant human brain natriuretic peptide combinedwith naoxintong capsule can effectively relieve clinical symptoms and improve the prognosis of patients with acute heart failure,has certain clinical effect and is safe.