注射用益气复脉(冻干)联合重组人脑利钠肽治疗心房颤动伴慢性心力衰竭的临床研究

Clinical study of Yiqi Fumai Lyophilized Injection combined with recombinant human brain natriuretic peptide in treatment of atrial fibrillation with chronic heart failure

目的探讨注射用益气复脉(冻干)联合重组人脑利钠肽治疗心房颤动伴慢性心力衰竭患者的临床疗效。方法回顾性收集2018年9月—2020月12月在贵州医科大学附属乌当医院心血管内科住院的房颤伴慢性心衰患者203例为研究对象,按治疗方法不同将患者分为对照组(n=97)和联合组(n=106)。所有入组的患者均进行常规的抗心衰治疗。对照组患者在常规治疗的基础上给予注射用重组人脑利钠肽,首次给药剂量为0.15μg/kg、iv给药,后以0.075μg/(kg·min)的速度,持续静脉泵入72 h。联合组在对照组治疗的基础上加用注射用益气复脉(冻干)5.2 g药液溶至5%葡萄糖注射液250 mL中,静脉滴注,1次/d,连续治疗14 d。治疗1个月后对两组患者进行疗效评价及脑利钠肽(BNP)、左室射血分数(LVEF)、6分钟步行试验(6MWT)检测。结果联合组的临床治疗总有效率为81.1%,明显高于对照组的67.0%(P<0.05)。治疗前两组患者BNP、LVEF、6MWT差异无统计学意义(P>0.05),经治疗后各组上述指标与治疗前比差异有统计学意义(P<0.05)。治疗后联合组BNP下降更为明显(P<0.05),LVEF升高更明显(P<0.05),6WMT增加更明显(P<0.05)。结论注射用益气复脉(冻干)联合重组人脑利钠肽治疗心房颤动伴慢性心力衰竭患者可明显提高患者临床总有效率,对患者LVEF、6MWT及BNP有明显的改善作用。

Objective To investigate the clinical efficacy of Yiqi Fumai Lyophilized Injection combined with recombinant human brain natriuretic peptide in treatment of atrial fibrillation with chronic heart failure.Methods Total 203 patients with atrial fibrillation and chronic heart failure hospitalized in the Department of Cardiology,Wudang Hospital Affiliated to Guizhou Medical University from September 2018 to December 2020 were collected retrospectively.According to different treatment methods,the patients were divided into control group(n=97)and combined group(n=106).All patients were treated with routine anti heart failure treatment.The patients in the control group were given recombinant human brain natriuretic peptide for injection on the basis of routine treatment,and the first dose was 0.15μg/kg intravenously,followed by 0.075μg/(kg·min)for 72 hours.On the basis of the treatment of the control group,patients in the combined group added 5.2 g of Yiqi Fumai Lyophilized Injection for injection into 250 mL of 5%glucose injection,intravenous drip,once a day,for 14 days.One month after treatment,the curative effect of the two groups were evaluated and brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)and 6-minute walking distance(6MWT)were measured.The total clinical effective rates of the two groups were compared by binary logistic regression analysis.Results The total effective rate of the combined group was 81.1%,which was significantly higher than 67.0%in the control group(P<0.05).Before treatment,there was significant difference in BNP,LVEF and 6MWT between the two groups(P<0.05).Before treatment,there was no significant difference in BNP,LVEF,and 6MWT between the two groups of patients(P>0.05).After treatment,the above indexes in each group were significantly different from those before treatment(P<0.05).There was significant difference in BNP level between the two groups after treatment,and BNP decreased more significantly in the combined group after treatment(P<0.05).There was significant difference in LVEF between the two groups after treatment,and LVEF increased more significantly in the combined group(P<0.05).There was significant difference in 6MWT between the two groups after treatment,and the increase of 6wmt in the combined group was more obvious after treatment(P<0.05).Conclusion Yiqi Fumai Lyophilized Injection combined with recombinant human brain natriuretic peptide can significantly improve the total clinical effective rate of patients with atrial fibrillation and chronic heart failure,and can significantly improve LVEF,6MWT and BNP.