冻干重组人脑利钠肽联合呋塞米治疗急性心肌梗死合并心力衰竭的效果观察

Effects of lyophilized recombinant human brain natriuretic peptide combined with furosemide on acute myocardial infarction complicated by heart failure

目的探讨冻干重组人脑利钠肽(rh-BNP)联合呋塞米治疗急性心肌梗死(AMI)合并心力衰竭的效果。方法抽取2019年1月至2021年2月濮阳市安阳地区医院收治的AMI合并心力衰竭患者480例,按随机数字表法分为研究组(240例)与对照组(240例)。对照组采用呋塞米治疗,研究组在对照组治疗基础上采用rh-BNP治疗。比较两组疗效、治疗前后症状评分(心悸、气短、乏力)、心功能[心排血量(CO)、左室射血分数(LVEF)、每搏输出量(SV)]、心肌酶谱[天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)]。结果研究组总有效率(97.92%,235/240)高于对照组(81.67%,196/240),差异有统计学意义(P<0.05)。治疗后,两组心悸、气短、乏力评分均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CO、LVEF、SV均较治疗前增高,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组AST、CK水平均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。结论rh-BNP联合呋塞米治疗AMI合并心力衰竭患者可提高治疗效果,调节心肌酶谱,改善心功能,缓解临床症状。

Objective To investigate the effects of lyophilized recombinant human brain natriuretic peptide combined with furosemide in the treatment of acute myocardial infarction(AMI)complicated by heart failure.Methods A total of 480 patients with AMI complicated by heart failure treated in Puyang Anyang Regional Hospital from January 2019 to February 2021 were selected and divided into study group(240 cases)and control group(240 cases)by random number table method.The control group was treated with furosemide,and the study group was treated with rh-BNP based on the treatment of control group.The curative effect,symptom score(palpitation,shortness of breath,fatigue),cardiac function assessed by cardiac output(CO),left ventricular ejection fraction(LVEF)and stroke volume(SV),and myocardial enzyme spectrum including aspartic transaminase(AST)and creatine kinase(CK)before and after treatment were compared between the two groups.Results The total effective rate of study group was 97.92%(235/240),higher than 81.67%(196/240)of control group(P<0.05).After treatment,the scores of palpitation,shortness of breath and fatigue in the two groups were lower than those before treatment,and these scores in study group were lower than those in control group(P<0.05).After treatment,the CO,LVEF,and SV of the two groups were higher than those before treatment,and these indicators of study group were higher than those of control group(P<0.05).After treatment,the levels of AST and CK of the two groups were lower than those before treatment,and study group had lower levels than control group(P<0.05).Conclusions The combination of rh-BNP and furosemide in the treatment of AMI patients with heart failure can improve the efficacy,regulate myocardial enzyme spectrum,improve heart function,and relieve clinical symptoms.