重组人脑利钠肽联合左西孟旦治疗急性心力衰竭患者的效果

Effects of recombinant human brain natriuretic peptide combined with Levosimendan in treatment of patients with acute heart failure

目的:观察重组人脑利钠肽(rhBNP)联合左西孟旦治疗急性心力衰竭(AHF)患者的效果。方法:选取70例AHF患者为研究对象,按随机数字表法分为对照组和观察组各35例。对照组静脉滴注左西孟旦治疗,观察组在对照组基础上联合rhBNP治疗。比较两组治疗24 h后的临床疗效,治疗前后神经内分泌激素[去甲肾上腺素(NE)、肾上腺素(E)、醛固酮(Ald)、血管紧张素Ⅱ(AngⅡ)]水平、心功能指标[左室射血分数(LVEF)、每搏输出量(SV)、心脏指数(CI)、N末端B型脑利钠肽(NT-proBNP)]水平及不良反应发生率。结果:观察组治疗总有效率为94.29%(33/35),高于对照组的74.29%(26/35),差异有统计学意义(P<0.05);治疗后,观察组NE、E、Ald、AngⅡ及NT-proBNP水平均低于对照组,LVEF、SV、CI水平均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:rhBNP联合左西孟旦治疗AHF患者可有效降低神经内分泌激素水平,改善患者心脏功能,效果优于单用左西孟旦治疗。

Objective:To explore effects of recombinant human brain natriuretic peptide(rhBN)combined with Levosimendan in treatment of patients with acute heart failure(AHF).Methods:70 AHF patients were selected as the research objects,and were divided into control group and observation group according to the random number table method,each with 35 cases.The control group was treated with intravenous infusion of Levosimendan,while the observation group was treated with rhBNP on the basis of that of the control group.After the treatment,the levels of neuroendocrine hormones[norepinephrine(NE),epinephrine(E),aldosterone(Ald),angiotensinⅡ(AngⅡ)],the cardiac function index levels[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac index(CI),N-terminal B-type brain natriuretic peptide(NT-proBNP)]levels and the adverse reaction before and after treatment were compared between the two groups.Results:The total effective rate in the observation group was 94.29%(33/35),which was higher than 74.29%(26/35)in the control group,and the difference was statistically significant(P<0.05).24 hours after the treatment,the levels of NE,E,Ald,AngⅡand NT-proBNP in the observation group were lower than those in the control group;the levels of LVEF,SV,and CI were higher than those in the control group;and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions:rhBNP combined with Levosimendan can effectively reduce the neuroendocrine hormone levels and improve the cardiac function in the patients with AHF.Moreover,it is superior to single Levosimendan.