rhBNP联合沙库巴曲缬沙坦钠片对急性心力衰竭患者的影响

Effects of rhBNP Combined with Sacubitril Valsartan Sodium Tablets on Patients with Acute Heart Failure

目的:探讨重组人脑利钠肽(rhBNP)联合沙库巴曲缬沙坦钠片对急性心力衰竭(AHF)患者的影响。方法:选取2021年3月-2022年3月在赤壁市蒲纺医院接受治疗的118例AHF患者。根据随机数字表法将其简单随机分为对照组(n=59)和观察组(n=59)。两组入院后均予以常规治疗,对照组在常规治疗基础上加用冻干rhBNP,观察组在对照组基础上加服沙库巴曲缬沙坦钠片。比较两组临床疗效,治疗前后心功能指标、神经内分泌细胞因子、炎症因子及不良反应。结果:观察组总有效率(93.22%)高于对照组(77.97%)(P<0.05)。治疗后,观察组N末端脑钠肽前体(NT-proBNP)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)均低于对照组,左室射血分数(LVEF)高于对照组(P<0.05)。治疗后,观察组血清可溶性致癌抑制因子2(sST2)、血管紧张素Ⅱ(AngⅡ)、醛固酮水平均低于对照组(P<0.05)。治疗后,观察组血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-33(IL-33)水平均低于对照组(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联合沙库巴曲缬沙坦钠片治疗AHF效果显著,能够有效调节神经内分泌细胞因子,抑制炎症反应,改善心功能。

Objective:To investigate the effects of Recombinant Human Brain Natriuretic Peptide(rhBNP)combined with Sacubitril Valsartan Sodium Tablets on patients with acute heart failure(AHF).Method:A total of 118 patients with AHF who were treated in Chibi Pufang Hospital from March 2021 to March 2022 were selected.They were simply and randomly divided into control group(n=59)and observation group(n=59)according to the random number table method.Both groups were given routine treatment after admission.The control group was added with freeze-dried rhBNP on the basis of routine treatment,and the observation group was added with Sacubitril Valsartan Sodium Tablets on the basis of the control group.The clinical efficacy,cardiac function indexes,neuroendocrine cytokines,inflammatory factors before and after treatment and adverse reactions were compared between the two groups.Result:The total effective rate of the observation group(93.22%)was higher than that of the control group(77.97%)(P<0.05).After treatment,N-terminal pro brain natriuretic peptide(NT-proBNP),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)in the observation group were lower than those in the control group,and left ventricular ejection fraction(LVEF)was higher than that in the control group(P<0.05).After treatment,the levels of serum soluble suppression of tumorigenicity 2(sST2),angiotensin Ⅱ(AngⅡ)and aldosterone in the observation group were lower than those in the control group(P<0.05).After treatment,serum high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)and interleukin-33(IL-33)in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:rhBNP combined with Sacubitril Valsartan Sodium Tablets has a significant effect on the treatment of AHF,which can effectively regulate neuroendocrine cytokines,inhibit inflammatory reaction and improve cardiac function.