冻干重组人脑利钠肽联合厄贝沙坦氢氯噻嗪片在急性心力衰竭伴高血压中的抢救效果及对N末端前体脑利钠肽水平变化的影响分析

Effect of Lyophilized Recombinant Human Brain Natriuretic Peptide Combined with Irbesartan Hydrochlorothiazide Tablets in the Rescue of Acute Heart Failure with Hypertension and Analysis of the Effect on the Change of N Terminal Pro B Type Natriuretic Peptide Level

目的:对冻干重组人脑利钠肽联合厄贝沙坦氢氯噻嗪片在急性心力衰竭(acute heart failure,AHF)伴高血压中的抢救效果及对N末端前体脑利钠肽(N terminal pro B type natriuretic peptide,NT-proBNP)水平变化的影响进行分析,进一步探寻其在AHF伴高血压病患中的抢救效果和对NT-proBNP水平的影响。方法:选取2020年4月—2021年12月襄城县人民医院心内科收治的97例AHF伴高血压患者作为研究对象,按随机数表法将患者分为对照组(n=43)和观察组(n=54),其中对照组采用口服厄贝沙坦氢氯噻嗪片治疗,观察组在对照组基础上联合冻干重组人脑利钠肽治疗。对比两组患者抢救总有效率、康复和临床指标、心脏彩超结果以及不良反应发生率。结果:治疗后,观察组的抢救总有效率为94.44%,高于对照组的86.05%,差异有统计学意义(χ^(2)=3.998,P<0.05);治疗后,观察组的康复指标状况较对照组更佳,差异有统计学意义(t=4.268、9.168、12.574,P<0.05);治疗后,两组患者的临床指标较治疗前更低,且观察组的NT-proBNP、糖类抗原125 (carbohydrate antigen 125,CA-125)、伴乳凝素-3 (galectin 3,Gal-3)、心肌肌钙蛋白I (cardiac troponin I,CTN I)水平较对照组更低,差异有统计学意义(t=16.291、4.633、7.556、6.041,P<0.05);治疗后,两组患者的心脏彩超结果较治疗前更高,且观察组的左室射血分数(left ventricular ejection fractions,LVEF)、每搏输出量(stroke volume,SV)、计算心输出量(calculation of cardiac output,CO)、心脏指数(cardiac index,CI)较对照组更高,差异有统计学意义(t=5.205、3.005、3.913、8.045,P<0.05);治疗后,观察组的不良反应发生率较对照组更低,差异有统计学意义(χ^(2)=13.488,P<0.05)。结论:冻干重组人脑利钠肽联合厄贝沙坦氢氯噻嗪片在AHF伴高血压中的抢救效果较好,能够改善病患心功能,降低NT-proBNP水平,且药副作用小。

Objective:The effect of lyophilized recombinant human brain natriuretic peptide in combination with irbesartan hydrochlorothiazide tablets in acute heart failure(AHF) with hypertension and the effect on the change of N-terminal precursor brain natriuretic peptide(NT-proBNP) level were analyzed to further investigate its effect in AHF with hypertension and the effect on NT-proBNP level.Methods:97 patients with AHF with hypertension admitted to the hospital from April 2020 to December 2021were selected for the study, and the patients were divided into control group(n=43) and observation group(n=54) according to the random number table method. The control group was treated with oral irbesartan hydrochlorothiazide tablets, and the observation group was treated with lyophilized recombinant human brain natriuretic peptide on this basis. The total resuscitation efficiency, recovery and clinical indices, cardiac ultrasound findings, and the rate of adverse events were compared between the two groups.Results:After treatment, the total effective rate of resuscitation in the observation group was 94.44%, which was higher than 86.05%in the control group, and the difference was statistically significant(χ^(2)=3.998, P<0.05). After treatment, the status of recovery indicators was better in the observation group than in the control group, and the difference was statistically significant(t=4.268, 9.168,12.574, P<0.05). After treatment, the clinical indicators were lower in both groups than before treatment, and the levels of NT-proBNP, glycoantigen 125(CA-125), concomitant lactin-3(Gal-3), and cardiac troponin I(CTN I) were lower in the observation group than in the control group, with statistically significant differences(t=16.291, 4.633, 7.556, 6.041, P<0.05). After treatment, cardiac ultrasound results were higher in both groups than before treatment, and left ventricular ejection fraction(LVEF), output per beat(SV), calculated cardiac output(CO), and cardiac index(CI) were higher in the observation group than in the control group, with statistically significant differences(t=5.205, 3.005, 3.913, 8.045, P<0.05). After treatment, the adverse reaction rate was lower in the observation group compared with the control group, and the difference was statistically significant(χ^(2)=13.488, P<0.05).Conclusion:The combination of lyophilized recombinant human brain natriuretic peptide and irbesartan hydrochlorothiazide tablets is effective in the rescue of AHF with hypertension, which can improve the patients’ cardiac function and reduce NT-proBNP level with low side effect.