半饱和量西地兰在婴幼儿肺炎心力衰竭前期的应用研究

Application of semi-saturated amount of cedilan in the early stage of infantile pneumonia heart failure

目的评价半饱和量西地兰在婴幼儿肺炎心力衰竭前期的应用价值及安全性,并监测其治疗前后血浆B型钠尿肽前体(NT-proBNP)的变化,评价NT-proBNP在婴幼儿肺炎合并心力衰竭中的作用。方法选择2016年3月至2017年3月NT-proBNP大于750 pg/ml的216例婴幼儿肺炎住院患儿,随机分为常规治疗组、半饱和量西地兰组和饱和量西地兰组,治疗后观察3组的临床疗效及不良反应,同时分析比较治疗前后血浆B型钠尿肽水平的变化。结果半饱和量西地兰组和饱和量西地兰组在改善婴幼儿肺炎临床疗效、缩短病程、降低心力衰竭发生率方面与常规治疗组比较差异有统计学意义(P<0.05),两组均优于常规治疗组;半饱和量西地兰组和饱和量西地兰组在改善婴幼儿肺炎临床疗效、缩短病程、降低心力衰竭发生率方面差异无统计学意义(P>0.05);半饱和量西地兰组和饱和量西地兰组在西地兰不良反应发生率方面差异有统计学意义(P<0.05),半饱和量西地兰组低于饱和量西地兰组;常规治疗组、半饱和量西地兰组和饱和量西地兰组NT-proBNP水平在治疗前差异无统计学意义(P>0.05),常规治疗组NT-proBNP水平治疗后比治疗前明显升高,差异有统计学意义(P<0.05),半饱和量西地兰组和饱和量西地兰组治疗后NT-proBNP水平均比治疗前明显降低,差异有统计学意义(P<0.05),治疗后常规治疗组NT-proBNP水平比半饱和量西地兰组和饱和量西地兰组均明显升高,差异有统计学意义(P<0.05),治疗后半饱和量西地兰组与饱和量西地兰组NT-proBNP水平比较差异无统计学意义(P>0.05)。结论NT-proBNP可作为婴幼儿肺炎合并心力衰竭的早期预测指标,也可作为判断心力衰竭治疗效果的指标;半饱和量西地兰可有效防止婴幼儿肺炎心力衰竭前期心力衰竭的进展,且相对安全。

Objective To evaluate the application value and safety of semi-saturated amount of cedilan in the early stage of infantile pneumonia heart failure,to monitor the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)before and after treatment,and to evaluate the role of NT-proBNP in infantile pneumonia complicated with heart failure.Methods 216 infants with pneumonia with NT-proBNP greater than 750 pg/ml from March 2016 to March 2017 were randomly divided into conventional treatment group,semisaturated amount of cedilan group,and saturated amount of cedilan group.The clinical efficacy and adverse reactions of the three groups were observed after treatment,and the changes of plasma NT-proBNP levels before and after treatment were analyzed.Results Compared with conventional treatment,semi-saturated amount of cedilan and saturated amount of cedilan had significant effect on improving the clinical efficacy,shortening the course of disease,and decreasing the incidence of heart failure of infants with pneumonia(P<0.05),while there were no statistically significant differences between semi-saturated amount of cedilan group and saturated amount of cedilan group(P>0.05).The incidence of adverse reactions in semi-saturated amount of cedilan group was lower than that in saturated amount of cedilan group(P<0.05).There was no statistically significant difference in the level of NT-proBNP among the three groups before treatment(P>0.05);after treatment,the level of NT-proBNP in conventional treatment group increased(P<0.05),the levels of NT-proBNP in semi-saturated amount of cedilan group and saturated amount of cedilan group decreased(P<0.05),the level of NT-proBNP in conventional treatment group was higher than those in semi-saturated amount of cedilan group and saturated amount of cedilan group(P<0.05),while there was no statistically significant difference between semi-saturated amount of cedilan group and saturated amount of cedilan group(P>0.05).Conclusion NT-proBNP can be used as an early predictor of infantile pneumonia complicated with heart failure,and can also be used as an indicator to judge the therapeutic effect of heart failure.The semi-saturated amount of cedilan can effectively prevent the progression of heart failure in infants with pneumonia,with high safety.