重组人脑利钠肽治疗老年心力衰竭的临床研究

Clinical study of recombinant human brain natriuretic peptide in treatment of elderly patients with heart failure

目的探讨重组人脑利钠肽治疗老年心力衰竭的临床效果。方法选取2018年1月—2019年12月安庆市立医院收治的117例老年慢性心力衰竭患者作为研究对象,采用随机数字表法将患者分为对照组(59例)和观察组(58例)。两组患者接受吸氧、卧床休息和常规抗心力衰竭治疗。观察组在对照组治疗的基础上给予注射用重组人脑利钠肽,以1.5μg/kg的负荷剂量静脉推注,用1.5 mL 5%葡萄糖注射液稀释,然后以0.0075μg/(kg·min)连续输注72 h后,将速率控制为0.01μg/(kg·min)。两组疗程均为2周。观察两组患者的临床疗效,同时比较两组患者治疗前后的心功能和血清学指标水平。结果治疗后,观察组的临床疗效分布优于对照组(P<0.05)。治疗后,两组左室射血分数(LVEF)、每搏输出量(SV)值显著升高,左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)显著降低(P<0.05);且观察组治疗后的LVEF、SV值均高于对照组,LVEDd、LVESd值显著低于对照组(P<0.05)。治疗后,两组患者的血清超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)和同型半胱氨酸(Hcy)水平均显著降低(P<0.05),且观察组hs-CRP、BNP和Hcy水平均显著低于对照组(P<0.05)。结论重组人脑利钠肽治疗老年心力衰竭患者具有更好的临床效果,可有效改善患者的心脏功能,降低hs-CRP、BNP的水平,值得在临床上推广使用。

Objective To investigate the clinical effect of recombinant human brain natriuretic peptide in treatment of elderly patients with heart failure.Methods A total of 117 elderly patients with chronic heart failure admitted to Anqing Municipal Hospital from January 2018 to December 2019 were selected as the study subjects,and the patients were divided into the control group(59 cases)and the observation group(58 cases)by random number table method.Patients in two groups received oxygen,rest,and routine antiheart failure therapy.Patients in the observation group were injected with Recombinant Human Brain Natriuretic Peptide for injection on the basis of control group,at a load dose of 1.5μg/kg,diluted with 1.5 mL 5%glucose injection,and then continuously injected with 0.0075μg/(kg·min)for 72 h at a rate of 0.01μg/(kg·min).The course of treatment in both groups was 2 weeks.The clinical efficacy in two groups was observed,and the cardiac function and serological index levels before and after treatment of the two groups were compared.Results After treatment,the distribution of clinical efficacy in the observation group was better than that in the control group(P<0.05).After treatment,LVEF and SV values in two groups were significantly increased,while LVEDd and LVESd were significantly decreased(P<0.05).In addition,the values of LVEF and SV after treatment in the observation group were higher than those in the control group,and the values of LVEDd and LVESd were significantly lower than those in the control group(P<0.05).After treatment,serum hs-CRP,BNP and Hcy levels in two groups were significantly decreased(P<0.05),and the levels of hs-CRP,BNP and Hcy in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Recombinant human brain natriuretic peptide has a better clinical effect in treatment of elderly patients with heart failure,can effectively improve the cardiac function of patients,reduce the level of hs-CRP and BNP,and is worth promoting in clinical use.