重组人脑利钠肽与曲美他嗪联合应用于扩张型心肌病并心力衰竭患者中的效果研究

Study on the Effect of Recombinant Human Brain Natriuretic Peptide Combined with Trimetazidine in Patients with Dilated Cardiomyopathy and Heart Failure

目的探讨重组人脑利钠肽与曲美他嗪联合应用于扩张型心肌病(DCM)并心力衰竭患者中的效果。方法选择2018年1月-2019年12月该院收治的DCM并心力衰竭患者98例,以随机数表法划分为两组。对照组49例应用曲美他嗪治疗,研究组49例在此基础上应用重组人脑利钠肽治疗。比较两组临床疗效、治疗前后的心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)与左心室射血分数(LEVF)]与血清学指标[脑钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、内皮素-1(ET-1)],以及不良反应情况。结果研究组治疗的总有效率93.88%较对照组77.55%高,差异有统计学意义(χ^(2)=5.333,P<0.05)。治疗后,研究组LVESD(37.06±4.09)mm、LVEDD(52.65±3.06)mm较对照组(44.65±5.03)、(57.66±4.03)mm低,差异有统计学意义(t=8.195、6.931,P<0.05);LEVF(47.65±5.03)%较对照组(40.65±4.89)%高,差异有统计学意义(t=6.985,P<0.05);BNP(216.52±57.47)ng/L、AngⅡ(90.45±20.20)ng/L、ET-1(55.65±15.52)ng/L较对照组(305.32±53.51)、(119.85±26.40)、(70.45±16.77)ng/L低,差异有统计学意义(t=7.916、6.191、4.534,P<0.05)。研究组不良反应发生率4.08%与对照组6.12%对比差异无统计学意义(P>0.05)。结论重组人脑利钠肽与曲美他嗪联合应用于DCM并心力衰竭患者中具有显著的效果,适于临床推广。

Objective To investigate the effect of recombinant human brain natriuretic peptide combined with trimetazidine in patients with dilated cardiomyopathy(DCM)and heart failure.Methods A total of 98 patients with DCM and heart failure admitted to the hospital from January 2018 to December 2019 were selected and divided into two groups using a random number table method.49 cases in the control group were treated with trimetazidine,and 49 cases in the study group were treated with recombinant human brain natriuretic peptide on this basis.The clinical efficacy,cardiac function indexes before and after treatment[left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LEVF)]and serological indexes[brain natriuretic peptide(BNP),angiotensin Ⅱ(Ang Ⅱ),endothelin-1(ET-1)],and adverse reactions in the two groups were compared.Results The total effective rate of treatment in the study group was 93.88%higher than that in the control group(77.55%),and the difference was statistically significant(χ^(2)=5.333,P<0.05).After treatment,LVESD(37.06±4.09)mm and LVEDD(52.65±3.06)mm in the study group were lower than those in the control group(44.65±5.03)mm and(57.66±4.03)mm,and the difference was statistically significant(t=8.195,6.931,P<0.05),LEVF(47.65±5.03)%higher than the control group(40.65±4.89)%,and the difference was statistically significant(t=6.985,P<0.05);BNP(216.52±57.47)ng/L,AngⅡ(90.45±20.20)ng/L,ET-1(55.65±15.52)ng/L were lower than the control group(305.32±53.51)ng/L,(119.85±26.40)ng/L,(70.45±16.77)ng/L,and the difference was statistically significant(t=7.916,6.191,4.534,P<0.05).The incidence of adverse reactions in the study group was 4.08%compared with 6.12%in the control group,and there was no statistically significant difference(P>0.05).Conclusion The combination of recombinant human brain natriuretic peptide and trimetazidine in patients with DCM and heart failure has a significant effect and is suitable for clinical promotion.