重组人脑利钠肽治疗急性失代偿性心力衰竭的效果

Effect of recombinant human brain natriuretic peptide in the treatment of acute decompensated heart failure

目的探讨重组人脑利钠肽治疗急性失代偿性心力衰竭的临床效果。方法 98例急性失代偿性心力衰竭患者,依据随机数字抽取表法分为对照组和观察组,每组49例。两组患者均配合常规治疗,在此基础上对照组采用硝酸甘油治疗,观察组采用重组人脑利钠肽治疗。比较两组患者治疗前后血流动力学参数、脑钠肽水平及临床指标。结果治疗前,两组患者血流动力学参数、脑钠肽水平及临床指标比较差异无统计学意义(P>0.05);治疗后,观察组左心室射血分数为(40.14±4.21)%、中心静脉压为(8.77±1.15)cm H2O(1 cm Hg=0.098 k Pa)、脑钠肽为(3722.5±1515.6)μg/ml,优于对照组的(35.56±4.27)%、(10.74±1.53)cm H2O、(5224.7±1867.4)μg/ml,差异具有统计学意义(t=5.35、7.20、4.37,P<0.05);治疗后,观察组24 h尿量为(245.35±52.43)ml、心率为(72.11±2.86)次/min、呼吸频率为(18.53±1.29)次/min,均优于对照组的(184.65±41.74)ml、(85.11±3.92)次/min、(23.36±1.24)次/min,差异具有统计学意义(t=6.34、18.75、18.90,P<0.05)。结论重组人脑利钠肽作为增加心肌耗氧量的肌力药可有效增强心肌收缩,增加冠状动脉血流供应,应用在急性失代偿性心力衰竭治疗中能够稳定心率和呼吸频率,改善不良症状,降低死亡风险,临床治疗价值较高。

Objective To investigate the clinical effect of recombinant human brain natriuretic peptide in the treatment of acute decompensated heart failure. Methods 98 patients with acute decompensated heart failure were divided into control group and observation group according to random number decimation table method, 49 cases in each group. Patients of the two groups were treated with conventional treatment. On the basis of this, the control group was treated with nitroglycerin, and the observation group was treated with recombinant human brain natriuretic peptide. The hemodynamic parameters, brain natriuretic peptide levels and clinical indicators were compared between the two groups before and after treatment. Results Before treatment, there were no significant differences in the hemodynamic parameters,brain natriuretic peptide levels and clinical indicators between the two groups（P0.05）.After treatment,the left ventricular ejection fraction,central venous pressure and brain natriuretic peptide in the observation group was（40.14±4.21）%,（8.77±1.15）cm H2O（1 cm Hg=0.098 k Pa）and（3722.5±1515.6）μg/ml,which were significantly better than（35.56±4.27）%,（10.74±1.53）cm H2O and（5224.7±1867.4）μg/ml in the control group,the differences were statistically significant（t=5.35,7.20,4.37,P0.05）.After treatment,the urine volume of 24 h,heart rate and respiratory frequency in the observation group were（245.35±52.43）ml,（72.11±2.86）times/min and（18.53±1.29）times/min,which were significantly better than（184.65±41.74）ml,（85.11±3.92）times/min and（23.36±1.24）times/min in the control group,and the differences were statistically significant（t=6.34,18.75,18.90,P0.05）.Conclusion Recombinant human brain natriuretic peptide can enhance myocardial contraction and increase the supply of coronary artery blood flow.It can stabilize heart rate and respiratory frequency in the treatment of acute decompensated heart failure,improve the adverse symptoms and reduce the risk of death,and the clinical value is high.