重组人脑利钠肽治疗老年急性心肌梗死继发心力衰竭的效果分析

Effect Analysis of Recombinant Human Brain Natriuretic Peptide in Treatment of Heart Failure Secondary to Acute Myocardial Infarction in the Elderly

目的:研究重组人脑利钠肽治疗老年急性心肌梗死(AMI)继发心力衰竭的临床疗效。方法:选取2018年1月-2021年1月肇庆市第二人民医院住院治疗的100例老年AMI继发心力衰竭患者,通过随机数表法分为两组,各50例,参照组采纳临床常规治疗,试验组在参照组基础上采纳重组人脑利钠肽(rhBNP)治疗,比较两组患者治疗后临床疗效、心功能、心肌损伤指标及不良反应发生率。结果:试验组临床总有效率高于参照组,差异具有统计学意义(χ^(2)=10.714,P=0.001)。治疗前,两组患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)与肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、N末端脑钠肽前体(NT-proBNP)比较,差异无统计学意义(P>0.05);治疗后,试验组LVEDD、LVESD与cTnI、CK-MB、NT-proBNP均比参照组低,LVEF比参照组高,差异具有统计学意义(P<0.05)。试验组不良反应总发生率与参照组比较,差异无统计学意义(χ2=0.154,P=0.695)。结论:rhBNP可有效改善老年AMI继发心力衰竭患者心功能,缓解呼吸困难等症状,减轻心肌受损程度,且不良反应较少。

Objective:To study the clinical efficacy of recombinant human brain natriuretic peptide in the treatment of elderly patients with heart failure secondary to acute myocardial infarction(AMI).Methods:A total of 100 elderly patients with heart failure secondary to AMI who were hospitalized in Zhaoqing Second People's Hospital from January 2018 to January 2021 were selected and divided into two groups by random number table method,with 50 cases in each group.The reference group received routine clinical treatment,and the experimental group received recombinant human brain natriuretic peptide(rhBNP)treatment on the basis of the reference group.The clinical efficacy,cardiac function,myocardial injury indexes and the incidence of adverse reactions were compared between the two groups of patients after treatment.Results:The clinical total effective rate in the experimental group was higher than that in the reference group,and the difference was statistically significant(χ2=10.714,P=0.001).Before treatment,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),troponin I(cTnI),creatine kinase isoenzyme(CK-MB)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in two groups were compared,and the difference was not statistically significant(P>0.05).After treatment,LVEDD,LVESD,cTnI,CK-MB,NT-proBNP in the experimental group were lower than those in the reference group,and LVEF was higher than that in the reference group,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the experimental group and the reference group(χ2=0.154,P=0.695).Conclusion:rhBNP can effectively improve cardiac function,alleviate dyspnea and other symptoms,reduce the degree of myocardial damage in elderly patients with heart failure secondary to AMI,and have less adverse reactions.