硝普钠联合缬沙坦治疗急性心力衰竭的效果观察及其对血栓弹力图和B型尿钠肽的影响

Clinical observation of sodium nitroprusside and valsartan and their effect on thrombelastogram and B type natriuretic peptide in acute heart failure

目的观察硝普钠联合缬沙坦治疗急性心力衰竭效果及其对血栓弹力图(TEG)和B型尿钠肽(BNP)的影响。方法 80例急性心力衰竭患者随机分为对照组和研究组,对照组在常规治疗基础上给予硝普钠治疗,而研究组加用缬沙坦联合治疗。评估两组的疗效、TEG及BNP变化。结果研究组疗效优于对照组,而TEG最大振幅和BNP水平低于对照组(P<0.01),两组TEG指标中的凝固角、反应时间、凝血指数和30 min振幅衰减率差异无统计学意义(P>0.05)。结论硝普钠联合缬沙坦治疗急性心力衰竭疗效确切,可有效改善TEG最大振幅和BNP水平。

Objective To observe the clinical efficacy of sodium nitroprusside and valsartan and their effect on thrombelastogram（TEG） and B type natriuretic peptide（BNP） in acute heart failure（AHF）. Methods Eighty AHF patients were randomized to observation and control groups, and respectively treated with sodium nitroprusside plus valsartan and sodium nitroprusside based on conventional therapy. Clinical efficacy, TEG and BNP level were compared between two groups. Results Clinical efficacy was higher, while maximum amplitude of TEG and serum BNP level were lower in observation group compared with control group（P〈0.01）. However, TEG showed no significant difference of solidification angle, reaction time, coagulation index, and LY30 between the two groups（P〈0.05）. Conclusion Combined usage of sodium nitroprusside and valsartan is effective for AHF, and can improve the maximum amplitude of TEG and serum BNP level.