中重度心力衰竭治疗中NT-proBNP水平的变化情况及指导意义

Changes of NT-proBNP level in the treatment of moderate and severe heart failure and its guiding significance

目的研究分析中重度心力衰竭患者治疗中N端前脑钠肽(NT-proBNP)表达水平的变化情况,并探讨NT-proBNP水平对中重度心力衰竭患者治疗的指导意义。方法选择我院内科就诊的60例中重度心力衰竭患者与同期行健康体检的60例健康志愿者,分别设为心衰组和正常组,测定并比较两组的NT-proBNP水平。采取随机数字表法,将心衰组患者随机划分为观察组和对照组,各30例,对照组参照药品说明书应用美托洛尔,观察组根据NT-proBNP监测结果调整美托洛尔给药方案。比较观察组与对照组的美托洛尔用量、临床疗效、NT-proBNP水平及不良反应发生情况。结果心衰组的NT-proBNP水平显著高于正常组(P<0.05)。重度心衰组的NT-proBNP水平显著高于中度心衰组(P<0.05)。观察组的美托洛尔用量显著少于对照组(P<0.05)。观察组的临床治疗总有效率显著高于对照组(P<0.05)。治疗后,观察组与对照组的中、重度心衰组患者的NTproBNP水平均降低,且观察组中、重度心衰组患者的NT-proBNP水平均低于对照组(P<0.05)。观察组与对照组的不良反应总发生率无显著差异(P>0.05)。结论 NT-proBNP的表达水平在心力衰竭患者中呈异常增高状态,随着心功能受损程度的加重,其表达水平增高,而临床治疗心力衰竭时根据NT-proBNP监测结果实时调整药物治疗方案,可提高患者的临床疗效,确保用药安全。

Objective To study and analyze the changes of expression level of N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with moderate and severe heart failure, and to explore the guiding significance of NT-proBNP level in the treatment of patients with moderate and severe heart failure. Methods A total of sixty patients with moderate and severe heart failure treated in internal medicine department of our hospital and 60 healthy volunteers who underwent physical examination at the same time were selected and seted as heart failure group and normal group. The level of NT-proBNP was measured and compared between the two groups. The patients in the heart failure group were randomly divided into observation group and control group by random number table method, with 30 cases in each group, the control group was treated with metoprolol according to the drug instructions, while the observation group adjusted the metoprolol administration program according to the monitoring results of NT-proBNP.The dosage of metoprolol, clinical efficacy, NT-proBNP level and adverse reactions were compared between the observation group and the control group. Results The level of NT-proBNP in the heart failure group was significantly higher than that in the normal group(P<0.05). The level of NT-proBNP in severe heart failure group was significantly higher than that in moderate heart failure group(P<0.05). Metoprolol dosage in the observation group was significantly less than that in the control group(P<0.05). The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05). After treatment, the levels of NT-proBNP of moderate and severe heart failure group in the observation group and the control group decreased, and the level of NT-proBNP of moderate and severe heart failure group in the observation group were lower than those in the control group( P<0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(P >0.05). Conclusion The expression level of NT-proBNP abnormally increased in patients with heart failure. With the aggravation of heart function damage, the expression level of NT-proBNP increased. Real-time adjustment of drug treatment program according to NT-proBNP monitoring results in clinical treatment of heart failure can improve clinical efficacy of patients and ensure drug safety.