重组人脑利钠肽联合尼可地尔治疗缺血性心肌病伴心力衰竭患者的效果

Effects of recombinant human brain natriuretic peptide combined with Nicorandil in treatment of patients with ischemic cardiomyopathy and heart failure

目的:观察重组人脑利钠肽联合尼可地尔治疗缺血性心肌病伴心力衰竭患者的效果。方法:选取2021年6月至2022年6月汝阳县人民医院收治的96例缺血性心肌病伴心力衰竭患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各48例。对照组给予尼可地尔治疗,观察组在对照组基础上联合重组人脑利钠肽治疗。比较两组临床疗效,治疗前后心绞痛发作次数和6 min步行试验(6MWT)距离,左心室功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]水平,心肌损伤标志物[血浆脑钠肽(BNP)、血清肌钙蛋白I(cTnI)]水平及不良反应发生率。结果:观察组治疗总有效率为91.67%,高于对照组的75.00%,差异有统计学意义(P<0.05);治疗后,两组心绞痛发作次数均少于治疗前,且观察组少于对照组,两组6MWT距离均长于治疗前,且观察组长于对照组,差异有统计学意义(P<0.05);两组LVESD、LVESV水平均低于治疗前,且观察组低于对照组,两组LVEF水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组血浆BNP、血清cTnI水平均低于治疗前,且观察组低于对照组,差异有统计学意义(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:重组人脑利钠肽联合尼可地尔治疗缺血性心肌病伴心力衰竭患者,可提高临床疗效,减少心绞痛发作次数,改善心功能,降低心肌损伤标志物水平,效果优于单纯尼可地尔治疗。

Objective:To observe effects of recombinant human brain natriuretic peptide combined with Nicorandil in treatment of patients with ischemic cardiomyopathy and heart failure.Methods:A prospective study was conducted on 96 patients with ischemic cardiomyopathy and heart failure admitted to Department of Cardiology of Ruyang County People’s Hospital from June 2021 to June 2022.They were divided into control group and observation group according to the random number table method,48 cases in each.The control group was treated with Nicorandil,while the observation group was treated with recombinant human brain natriuretic peptide on the basis of that of the control group.The clinical efficacy,the frequency of angina pectoris attacks and the 6-minute walking test(6MWT)distance before and after the treatment,the left ventricular function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]levels,the myocardial injury markers[plasma brain natriuretic peptide(BNP),serum troponin I(cTnI)]levels,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 91.67%,which was higher than 75.00%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the number of weekly episodes of angina pectoris in the two groups was less than that before the treatment,and that in the observation group was less than that in the control group;the 6MWT distance of the two groups was longer than that before the treatment,and that in the observation group was longer than that in the control group;and the differences were statistically significant(P<0.05).The levels of LVESD and LVESV in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the LVEF levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).The levels of plasma BNP and serum cTnI in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Recombinant human brain natriuretic peptide combined with Nicorandil in the treatment of the patients with ischemic cardiomyopathy and heart failure can improve the clinical efficacy,reduce the number of weekly episodes of angina pectoris,improve the cardiac function,and reduce the levels of myocardial injury markers.Moreover,it is superior to single Nicorandil treatment.