康复训练联合重组人脑利钠肽+达格列净治疗慢性心力衰竭的临床疗效

Clinical efficacy of rehabilitation training combined with recombinant human brain natriuretic peptide and Dapagliflozin in the treatment of chronic heart failure

目的探讨康复训练联合重组人脑利钠肽(rh-BNP)+达格列净治疗慢性心力衰竭(CHF)的临床疗效。方法选取辽宁省某医院2019年1-10月收治的129例CHF患者作为研究对象,采用随机数字表法分为对照组(64例)和观察组(65例)。对照组患者给予康复训练联合rh-BNP治疗,观察组患者在对照组基础上给予达格列净治疗。比较2组患者临床疗效、预后情况及治疗前后心功能指标、血清指标、6 min步行试验距离、生活质量。结果观察组患者治疗总有效率为96.92%(63/65),高于对照组的85.94%(55/64),差异有统计学意义(χ^(2)=4.989,P<0.05)。2组患者治疗后左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)小于治疗前且观察组小于对照组,左心室射血分数(LVEF)大于治疗前且观察组大于对照组,差异均有统计学意义(P<0.05)。2组患者治疗后血清白介素-6(IL-6)、氨基末端脑钠肽前体(NT-proBNP)水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者治疗后6 min步行试验距离大于治疗前且观察组大于对照组,明尼苏达心力衰竭生活质量问卷(MLHFQ)评分低于治疗前且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者随访12个月再次入院治疗发生率为29.69%(19/64),低于对照组的12.31%(8/65),差异有统计学意义(χ^(2)=5.886,P<0.05)。结论康复训练联合rh-BNP+达格列净治疗CHF疗效确切,有助于改善患者心功能,减轻炎症反应,提高生活质量且预后较好。

Objective To explore the clinical efficacy of rehabilitation training combined with recombinant human brain natriuretic peptide(rh-BNP)and Dapagliflozin in the treatment of chronic heart failure(CHF).Methods A total of 129 patients with CHF treated in a hospital in Liaoning Province from January 2019 to October 2019 were randomly divided into control group(n=64)and observation group(n=65).The patients in the control group were given rehabilitation training combined with rh-BNP treatment,while the patients in the observation group were treated with Dapagliflozin on the basis of the control group.The clinical efficacy,prognosis,cardiac function index,serum index,distance of 6 min walking test and quality of life before and after treatment were compared between the two groups.Results The total effective rate of patients in the observation group was 96.92%(63/65),which was higher than that in the control group(85.94%)(55/64).The difference was statistically significant(χ^(2)=4.989,P<0.05).After treatment,the left ventricular end-systolic diameter(LVESD)and left ventricular enddiastolic diameter(LVEDD)in the two groups were smaller than those before treatment,and those in the observation group were smaller than those in the control group.After treatment,the left ventricular ejection fraction(LVEF)in the two groups was significantly higher than that before treatment,and that in the observation group was higher than that in the control group;the differences were statistically significant(P<005).The levels of serum interleukin-6(IL-6)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the two groups after treatment were lower than those before treatment,and those in the observation group were lower than those in the control group;the differences were statistically significant(P<0.05).The distance of 6 min walking test in the two groups after treatment was longer than that before treatment,and that in the observation group was longer than that in the control group.The MLHFQ in the two groups was lower than that before treatment,and that in the observation group was lower than that in the control group;the differences were statistically significant(P<0.05).After 12-month follow-up,the incidence of re-admission in the observation group(29.69%)(19/64)was lower than that in the control group(12.31%)(8/65).The difference was statistically significant(χ^(2)=5.886,P<0.05).Conclusion Rehabilitation training combined with rh-BNP and Dapagliflozin is effective in the treatment of CHF,which can help to improve the cardiac function,reduce the inflammatory,improve the quality of life and have a good prognosis.