重组人脑利钠肽改善慢性心力衰竭利尿剂抵抗的作用观察

Effects of Recombinant Human Brain Natriuretic Peptide on Improving Diuretic Resistance in Chronic Heart Failure

目的:研究重组人脑利钠肽运用于慢性心力衰竭利尿剂抵抗的价值。方法:选择本院2018年12月~2020年6月纳入的156例慢性心力衰竭利尿剂抵抗患者为研究对象,依照随机双盲法分成重组人脑利钠肽组(A组)和常规治疗组(B组),每组78例。对两组总有效率进行评估,同时在用药前后测定两组的左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、心率(HR)、尿素氮(BUN)、肌酐(SCr)、胱抑素C(Cys-C)、脑钠肽(NT-proBNP)、白介素-2(IL-2)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,对比两组用药结果。结果:A组总有效率(88.46%)高于B组(74.36%,P<0.05)。用药前两组的各项指标对比无统计学差异(P>0.05),用药后A组的LVEF、LVEDD、LVESD、HR、BUN、SCr、Cys-C、NT-proBNP、IL-2、IL-6、TNF-α均优于B组(P<0.05)。用药1周后A组速尿量、尿量高于B组(P<0.05)。结论:重组人脑利钠肽运用于慢性心力衰竭利尿剂抵抗的效果良好,能够有效减轻利尿剂抵抗,促进患者心功能改善,减轻炎症反应,同时快速稳定病情,为预后提供保障。

Objective:To study the value of recombinant human brain natriuretic peptide on improving diuretic resistance in chronic heart failure.Methods:A total of 156 chronic heart failure patients with diuretic resistance treated from December 2018 to June 2020 in our hospital were selected.According to random double-blind method,patients were divided into group A(n=78,recombinant human brain natriuretic peptide)and group B(n=78,routine treatment).The total effective rate of both groups was assessed.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),heart rate(HR),blood urea nitrogen(BUN),serum creatinine(SCr),cystatin C(Cys-C),N-terminal pro-B-type natriuretic peptide(NT-proBNP),interleukin-2(IL-2),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)of two groups were measured before and after medication.The results of medication were compared between the two groups.Results:Total effective treatment rate in group A(88.46%)was higher than group B(74.36%,P<0.05);before medication,clinical indicators between two groups showed no statistically significant difference(P>0.05);after medication,LVEF,LVEDD,LVESD,HR,BUN,SCr,Cys-C,NT-proBNP,IL-2,IL-6 and TNF-αlevels in group A were significantly better than those in group B(P<0.05).After one week of medication,the furosemidum usage volume and urine volume in group A were larger than that in group B(P<0.05).Conclusion:The effect of recombinant human brain natriuretic peptide on diuretic resistance in chronic heart failure is more prominent.It can effectively reduce the diuretic resistance and inflammatory response,stabilize the illness state,and improve the cardiac function and treatment prognosis.