注射用辅酶Ⅰ对老年患者瓣膜置换联合冠脉搭桥术后早期预后的影响

The effect of coenzyme Ⅰ for injection on the early prognosis of elderly patients after valve replacement combined with coronary artery bypass grafting

目的探讨注射用辅酶I(NAD+)对老年患者行瓣膜置换联合冠脉搭桥术后早期预后的影响。方法选取2019年7月至2020年3月在武汉亚洲心脏病医院行瓣膜置换联合冠脉搭桥术的54例老年患者作为研究对象,采用随机数字表法分为研究组(27例)和对照组(27例),对照组采用常规治疗,研究组在常规治疗的基础上加用NAD+。比较两组患者手术前后左心室射血分数(LVEF)、N末端B型利钠肽前体(NT-proBNP)水平、心腔大小,并观察术后并发症的发生情况。结果术后7 d,研究组NT-proBNP指标低于对照组,差异有统计学意义(P<0.05),而两组的LVEF比较,差异无统计学意义(P>0.05);术后7 d,两组治疗后的左心房、左心室大小比较,差异无统计学意义(P>0.05);术后两组无死亡病例,无二次开胸;在术后其他并发症上,研究组出现心房颤动4例(14.81%),胸腔积液18例(66.67%),对照组出现心房颤动7例(25.92%),胸腔积液23例(85.18%)。研究组术后并发症的发生率低于对照组,但差异无统计学意义(P>0.05)。结论瓣膜置换联合冠脉搭桥术后使用NAD+对老年患者的早期预后有积极作用。

Objective To investigate the effect of coenzyme I for injection(NAD+)on the early prognosis of elderly patients undergoing valve replacement combined with coronary artery bypass grafting.Methods A total of 54 elderly patients who underwent valve replacement combined with coronary artery bypass surgery at Wuhan Asia Heart Hospital from July 2019 to March 2020 were selected as the research objects and divided into the study group(27 cases)and the control group(27 cases)by random number table method.The control group received conventional treatment,and the study group received NAD+on the basis of conventional treatment.The left ventricular ejection fraction(LVEF),N-terminal pro-B type natriuretic peptide(NT-proBNP)levels,and the size of the heart cavity were compared between the two groups of patients before and after surgery.The occurrence of postoperative complications was observed.Results 7 days after operation,the NT-proBNP in the study group was lower than that in the control group,with a statistically significant difference(P<0.05).While,there was no significant difference in LVEF between the two groups 7 days after operation(P>0.05).7 days after operation,there were no significant differences in the size of left atrium and left ventricle between the two groups(P>0.05).There were no death or second thoracotomy in the two groups after operation.In terms of other postoperative complications,atrial fibrillation occurred in 4 cases(14.81%)and pleural effusion in 18 cases(66.67%)in the study group,while atrial fibrillation occurred in 7 cases(25.92%)and pleural effusion in 23 cases(85.18%)in the control group.The incidence of postoperative complications in the study group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The use of NAD+after valve replacement combined with coronary artery bypass surgery has a positive effect on the early prognosis of elderly patients.