磷酸肌酸联合新活素对冠心病冠状动脉介入术后患者血流动力学及脑钠肽等的影响

Effect of creatine phosphate combined with recombinant human brain natriuretic peptide on hemodynamic parameters and BNP levels in patients with coronary artery disease undergoing coronary intervention

目的观察冠心病患者冠状动脉介入术后应用磷酸肌酸联合新活素对血流动力学指标及脑钠肽(BNP)等水平的影响。方法选择2015年9月—2016年9月大连市第三人民医院心内科行冠状动脉介入治疗的冠心病患者90例作为研究对象,随机数字表法分成2组各45例。对照组予以常规治疗加新活素治疗,观察组在对照组基础上加用磷酸肌酸治疗。比较2组临床治疗效果及治疗前后血清心肌损伤标志物(MDA、CK-MB、c Tn I)、血流动力学指标、BNP水平的变化。结果治疗2周后,观察组总有效率为93.3%,显著高于对照组的77.8%(χ~2=4.406,P=0.036);2组血清MDA、CK-MB、c Tn I水平均较治疗前上升,但观察组上升程度低于对照组(t=6.192、7.807、5.094,P均=0.000);2组LVEF、FPV、SV水平均较治疗前上升,并且观察组上升更为显著(t=5.260、5.830、6.216,P均=0.000);2组BNP水平均较治疗前下降,并且观察组下降更显著(t=8.157,P=0.000)。结论冠心病患者冠状动脉介入术后应用磷酸肌酸联合新活素治疗对于心肌再灌注损伤具有一定的保护作用,能够显著改善患者的血流动力学指标及BNP水平,具有一定的临床意义。

Objective To analyze and investigate the effect of creatine phosphate combined with recombinant human brain natriuretic peptide on hemodynamic parameters and BNP levels in patients with coronary artery disease undergoing coro -nary intervention.Methods Ninety cases of patients with coronary artery disease undergoing coronary intervention were se -lected,which were treated in hospital from September 2015 to September 2016, and they were divided into the observation group（45 cases）and control group（45 cases）.The patients of control group were treated with recombinant human brain na-triuretic peptide.On the basis of the control group,the patients of observation group were treated with creatine phosphate.The patients of two groups were all treated for 3 months in a row.Observe and compare the clinical treatment effect and the changes of hemodynamic parameters and BNP levels of two groups.Results After the appropriate treatment,the patients of the obser-vation group got a total effective rate of 93.3%, which was significantly better than the 77.8% of the control group（χ2=4.406,P =0.036）;The serum MDA, CK-MB, cTnI levels of the two groups were all significantly increased than before, and the patients of the control group got more significant increase（t =6.192,t =7.807,t =5.094,P =0.000,P =0.000,P =0.000）;The LVEF,FPV,SV levels of the two groups were all significantly increased than before,and the pa-tients of the observation group got more significant increase（t =5.260,t =5.830,t =6.216,P =0.000,P =0.000,P =0.000）;The BNP levels of the two groups were all significantly decreased than before, and the patients of the observation group got more significant decline（t =8.157,P =0.000）.Conclusion In the treatment of patients with coronary artery disease undergoing coronary intervention,creatine phosphate combined with recombinant human brain natriuretic peptide can play a role in myocardial reperfusion injury, significantly improve the patient＆#39;s hemodynamic parameters and BNP levels, which provides a certain clinical significance.