重组人脑利钠肽联合沙库巴曲缬沙坦对NSTEMI并发急性心力衰竭患者的影响

Effect of Recombinant Human Brain Natriuretic Peptide and Sacubitril Valsartan in NSTEMI Patients with Acute Heart Failure

目的:研究重组人脑利钠肽联合沙库巴曲缬沙坦运用于非ST段抬高型心肌梗死(NSTEMI)并发急性心力衰竭患者中的价值。方法:选择2020年8月—2022年3月广东省河源市人民医院诊断为NSTEMI并发急性心力衰竭的住院患者共70例,通过随机数字表法分为研究组与对照组,各35例。研究组采用重组人脑利钠肽及沙库巴曲缬沙坦治疗,对照组采用重组人脑利钠肽及缬沙坦治疗。比较两组的总有效率、心率、血压及尿量、左心射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、氨基末端B型脑钠肽前体(NT-proBNP)、主要心血管不良事件(MACE)。结果:研究组总有效率(88.57%)高于对照组(68.57%),差异有统计学意义(P<0.05)。用药前,两组的心率、血压、尿量、肌酐、血钾比较,差异均无统计学意义(P>0.05);用药后72 h、7 d,研究组心率、收缩压、舒张压、肌酐均低于对照组,而尿量较对照组高,差异均有统计学意义(P<0.05);两组血钾比较,差异均无统计学意义(P>0.05)。用药前,两组的心功能及NT-proBNP比较,差异均无统计学意义(P>0.05)。用药后3、6个月,研究组的LVEF高于对照组,但LVEDD、LVESD、NT-proBNP均较对照组降低,差异均有统计学意义(P<0.05)。研究组心脏不良事件的发生率较对照组更低(P<0.05)。结论:重组人脑利钠肽联合沙库巴曲缬沙坦能够积极控制患者血压及心率,促进心功能改善,减少心脏不良事件的发生。

Objective:To study the value of Recombinant Human Brain Natriuretic Peptide and Sacubitril Valsartan in non-ST segment elevation myocardial infarction(NSTEMI)patients with acute heart failure.Method:A total of 70 hospitalized patients diagnosed with NSTEMI and acute heart failure treated from August 2020 to March 2022 in Heyuan People's Hospital were selected,they were divided into a study group and a control group by random number table method,with 35 cases in each group.The study group received treatment with Recombinant Human Brain Natriuretic Peptide and Sacubitril Valsartan,while the control group received treatment with Recombinant Human Brain Natriuretic Peptide and Valsartan.The total effective rate,heart rate,blood pressure,urine volume,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)and major adverse cardiovascular events(MACE)between the two groups were compared.Result:The total effective treatment rate in the study group(88.57%)was higher than that in the control group(68.57%),the difference was statistically significant(P<0.05).Before medication,there were no statistically significant differences in heart rate,blood pressure,urine output,creatinine,and blood potassium between the two groups(P>0.05);72 hours and 7 days after medication,the heart rate,systolic blood pressure,diastolic blood pressure,and creatinine in the study group were lower than those in the control group,while urine output was higher than that in the control group,the differences were statistically significant(P<0.05);there were no statistically significant differences in blood potassium between the two groups(P>0.05).Before medication,there were no statistically significant differences in heart function and NT-proBNP between the two groups(P>0.05).After 3 and 6 months of medication,the LVEF of the study group was higher than that of the control group,but LVEDD,LVESD,and NT-proBNP were all lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse cardiac events in the study group was lower than that in the control group(P<0.05).Conclusion:The Recombinant Human Brain Natriuretic Peptide and Sacubitril Valsartan can effectively control the blood pressure and heart rate,improve the cardiac function and reduce the incidences of adverse cardiovascular events.