冻干重组人脑利钠肽、左西孟旦对急性失代偿性心力衰竭患者的临床疗效及对血清血管紧张素Ⅱ、内皮素的影响

Effect of Lyophilized Recombinant Human Brain Natriuretic Peptide and Levosimendan on the Clinical Efficacy and AngiotensinⅡand Endothelin in Patients with Acute Decompensated Heart Failure

目的比较冻干重组人脑利钠肽和左西孟旦对急性失代偿性心力衰竭(ADHF)患者的心功能、血管紧张素Ⅱ(AngⅡ)、内皮素(ET)的影响。方法选取川北医学院附属大竹县人民医院2019年6—12月收治的100例ADHF患者作为研究对象,随机分为A组和B组,各50例。在常规治疗基础上A组联合冻干重组人脑利钠肽治疗,B组联合左西孟旦。比较两组治疗前后24 h尿量、6 min步行距离、心率、呼吸频率、脑钠肽(BNP)、心功能指标、AngⅡ、ET变化。结果治疗后两组24 h尿量、6 min步行距离较治疗前增加,心率、呼吸频率、BNP降低,且A组降低或升高幅度大于B组,差异有统计学意义(P<0.05)。治疗后两组左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、心脏指数(CI)、心排血量(CO)较治疗前增加,左心室收缩末期内径(LVESD)降低,且A组降低或升高幅度大于B组,差异有统计学意义(P<0.05)。治疗后两组AngⅡ、ET较治疗前降低,且A组降低幅度大于B组,差异有统计学意义(P<0.05)。结论冻干重组人脑利钠肽可有效改善ADHF患者心功能,降低BNP、AngⅡ、ET水平,治疗效果优于左西孟旦。

Objective To compare the effect of lyophilized recombinant human brain natriuretic peptide(rhBNP)and levosimendan on the cardiac function,AngiotensinⅡ(AngⅡ)and Endothelin(ET)in patients with acute decompensated heart failure(ADHF).Methods A total of 100 ADHF patients admitted to the Dazhu County People’s Hospital of North Sichuan Medical College from June to December 2019 were selected as the research objects and were randomly assigned into group A(n=50)and group B(n=50).The 24 h urine volume,6-min walking distance,heart rate,respiratory rate,cardiac function index,BNP,AngⅡ,and ET were compared before and after treatment.Results Compared with those before treatment,24 h urine volume and 6min walking distance increased,heart rate and respiratory frequency and BNP decreased in the 2 groups of after treatment,and the decrease or increase in group A was greater than that in group B,and the difference was statistically significant(P<0.05).After treatment,left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),cardiac index(CI),cardiac output(CO)increased compared with those before treatment in the 2 groups.Ventricular end systolic diameter(LVESD)decreased,and the decrease or increase in group A was greater than that in group B,the difference was statistically significant(P<0.05).After treatment,AngⅡand ET decreased in the 2 groups compared with those before treatment,and the decrease in group A was greater than that in group B,the difference was statistically significant(P<0.05).Conclusion Recombinant human brain natriuretic peptide can effectively improve the heart function of ADHF patients,reduce the levels of BNP,AngⅡ,ET,and have a better therapeutic effect than levosimendan.