新活素治疗老年顽固性心力衰竭的疗效观察

Clinical curative effect of rh BNP in treatment of senile intractable heart failure

目的观察新活素(重组人脑利钠肽,rh BNP)治疗老年顽固性心力衰竭的临床疗效。方法选取2015年3月—2017年2月于蚌埠市第二人民医院住院治疗的顽固性心力衰竭老年患者94例为研究对象,根据随机数字表法将患者分为观察组和对照组,观察组47例,对照组47例,对照组采用心力衰竭常规治疗方案,给予多巴胺或洋地黄类强心剂、血管紧张素抑制剂类药物、呋塞米利尿剂等药物治疗,观察组在对照组治疗基础上,给予患者新活素治疗。观察比较治疗前后患者血清氨基末端脑钠肽前体(NT-pro BNP)水平、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、心率变化以及药物不良反应。结果经药物治疗,观察组用药7 d后顽固性心力衰竭的治疗有效率显著高于对照组(P<0.01),差异有统计学意义;与治疗前相比,治疗后2组患者NT-pro BNP值明显下降,LVEF升高,心率降低,差异有统计学意义(均P<0.05);与对照组治疗后相比,观察组NT-pro BNP值显著降低,LVEF明显升高,心率显著降低,差异有统计学意义(均P<0.05);不良反应率在2组患者中比较差异无统计学意义(P>0.05)。结论新活素治疗老年顽固性心力衰竭能够明显改善患者心衰临床症状和心功能,显著降低NT-pro BNP水平,提高LVEF分值,降低患者心率,同时无明显药物不良反应。新活素治疗老年顽固性心力衰竭疗效显著,改善顽固性心力衰竭患者临床症状,安全可行。

Objective To observe the clinical efficacy of rhBNP in the treatment of senile patients with refractory heart failure. Methods Total 94 patients with refractory heart failure in the second hospital of Bengbu from March, 2015 to February, 2017 were enrolled into this study. The patients were randomly divided into observation group and control group according to random number table, with 47 cases in each group. The control group was adopted routine treatment for heart failure, such as dopamine or digitalis, angiotensin inhibitors, furosemide diuretics. The observation group was given rhBNP based on the control group. The clinical symptoms, signs and cardiac function were observed before and af- ter the treatment. The levels of serum of NT-proBNP, left ventrieular ejection fraction （ LVEF）, left ventrieular end dias- tolic diameter （LVEDd）, heart rate and adverse drug reactions were observed in both groups before and after the treat- ment for 7 days. Results After the treatment, the effective rate of ameliorating refractory heart failure was significantly higher in the observation group than that in the control group （P 〈 0.01 ）, and the difference was statistically significant. Compared with the control group, the NT-proNBP value of the observation group was significantly decreased, the EF was significantly increased and the heart rate was significantly decreased, and the difference was statistically significant （ P 〈 0.05 ）. There was no significant difference in adverse reaction rate between the two groups （ P 〉 0.05 ）. Conclusion RhBNP treatment of elderly patients with refractory heart failure can significantly improve the clinical symptoms and cardi- ac function of patients with heart failure, significantly reduce the level of serum NT-proNBP, increase LVEF, reduce heart rate, while no significant adverse drug reaction. The curative effect of rhBNP is good on senile refractory heart fail- ure, and it can significantly improve the hemodynamic parameters without obvious significant adverse reactions.