重组人脑利钠肽和米力农联合抗凝治疗重症肺心病心力衰竭患者的疗效观察

Therapeutic effect of recombinant human brain natriuretic peptide and milrinone combined with anticoagulant therapy on patients with severe pulmonary heart disease and heart failure

目的探究重组人脑利钠肽、米力农联合抗凝治疗重症肺心病心力衰竭患者的效果观察。方法选取2020年2月~2022年10月收治的97例重症肺心病心力衰竭患者,按照随机数字法分为对照组(n=49)和观察组(n=48),其中对照组采用重组人脑利钠肽、米力农治疗,观察组采用重组人脑利钠肽、米力农联合抗凝治疗。比较两组患者的心功能、肺功能、心力衰竭和冠脉炎症指标,评估临床疗效。结果观察组总有效率高于对照组(P<0.05);治疗后观察组左室射血分数(LVEF)、每搏量(SV)、每分心排血量(CO)、用力肺活量(FVC)、第一秒用力呼吸容积(FEV1)、最高呼气流速(PEF)指标均高于对照组(P<0.05),观察组的左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)、最低心率(LHR)、白细胞介素-6(IL-6)、血清内皮素(EF-1)、超敏C反应蛋白(hs-CRP)、N末端B型利钠肽前体(NT-proBNP)指标均低于对照组(P<0.05)。结论重症肺心病心力衰竭患者采用重组人脑利钠肽、米力农联合抗凝治疗效果显著,可有效改善患者的临床症状,降低反映心力衰竭和冠脉炎症的指标,改善患者的心功能和肺功能。

Objective To observe the effect of recombinant human brain natriuretic peptide and milrinone combined with anticoagulant therapy on patients with severe pulmonary heart disease and heart failure.Methods 97 patients with severe pulmonary heart disease and heart failure were enrolled from February 2020 to October 2022,and were divided into control group(n=49)and observation group(n=48)according to random number method.The control group was treated with recombined human brain natriuretic peptide and milrinone.The observation group was treated with recombinant human brain natriuretic peptide and milrinone combined with anticoagulant therapy.The indexes of heart function,lung function,heart failure and coronary inflammation and clinical efficacy were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05),and the left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and peak expiratory flow(PEF)in the observation group were all higher than those in the control group(P<0.05).The indexes of left ventricular diastolic end diastolic diameter(LVEDd),left ventricular systolic end diastolic diameter(LVESd),lowest heart rate(LHR),interleukin-6(IL-6),serum endothelin(EF-1),hypersensitive C-reactive protein(hs-CRP)and N-terminal B-type natriuretic peptide(NT-proBNP)were all lower than those of the control group(P<0.05).Conclusion Recombinant human brain natriuretic peptide and milrinone combined with anticoagulant therapy are effective in patients with severe pulmonary heart disease and heart failure,which can effectively improve the clinical symptoms of patients,reduce the indicators of reactive heart failure and reactive coronary inflammation,and improve the heart and lung function of patients.