左西孟旦联合重组人脑利钠肽治疗急性心力衰竭的临床效果研究

Clinical effect of levosimendan combined with recombinant human brainnatriuretic peptide in the treatment of acute heart failure

目的研究左西孟旦联合重组人脑利钠肽(rhBNP)对急性心力衰竭患者的临床治疗效果。方法选取2019年12月至2021年12月该院急性心力衰竭患者100例作为研究对象。根据不同治疗方案,将受试者分为对照组、左西孟旦组、rhBNP组、联合治疗组,每组各25例。对照组接受传统常规利尿、扩管等治疗;左西孟旦组在对照组的治疗基础上加用左西孟旦;rhBNP组在对照组治疗的基础上加用rhBNP;联合治疗组在对照组的治疗基础上联合应用左西孟旦和rhBNP。记录各组患者纽约心脏协会(NYHA)分级改善情况、死亡情况、再住院率、6 min步行距离、血清学指标改善情况、不良反应发生情况等。结果治疗前,各组基线资料比较差异无统计学意义(P>0.05)。治疗后1、3 d,联合治疗组NYHA分级改善情况优于其他各组(P<0.05),左西孟旦组和rhBNP组NYHA分级改善情况优于对照组(P<0.05)。联合治疗组治疗后6个月内再住院率低于其他各组,差异有统计学意义(P<0.05)。治疗后5、9 d,联合治疗组6 min步行距离均长于其他各组(P<0.05)。治疗后9 d,联合治疗组左室射血分数(LVEF)高于其他各组(P<0.05),联合治疗组N末端B型利钠肽原(NT-proBNP)水平低于其他各组(P<0.05)。4组不良反应发生情况比较,差异均无统计学意义(P>0.05)。结论急性心力衰竭患者联合应用左西孟旦和rhBNP治疗在早期临床改善方面优于传统治疗和单药治疗,且不会增加不良反应发生率。

Objective To study the clinical effect of levosimendan combined with recombinant human brain natriuretic peptide(rhBNP)on patients with acute heart failure.Methods A total of 100 patients with acute heart failure in the hospital from December 2019 to December 2021 were selected as the research subjects.According to different treatment options,the subjects were divided into the control group,levosimendan group,rhBNP group and combined treatment group,with 25 cases in each group.The control group received traditional conventional diuretic,tube expansion and other treatment;the levosimendan group was treated with levosimendan on the basis of the control group;the rhBNP group was treated with rhBNP on the basis of the control group;the combined treatment group was treated with levosimendan and rhBNP on the basis of the control group.The improvement of New York Heart Association(NYHA)classification,death,rehospitalization rate,6-minute walking distance,improvement of serological indicators and adverse reactions were recorded in each group.Results Before treatment,there was no significant difference in baseline data between the groups(P>0.05).On the 1 st and 3 rd day after treatment,the improvement of NYHA classification in the combined treatment group was better than that in the other groups(P<0.05),and the improvement of NYHA classification in the levosimendan group and rhBNP group was better than that in the control group(P<0.05).The readmission rate within 6 months after treatment in the combined treatment group was lower than that in the other groups(P<0.05).At 5 and 9 days after treatment,the 6-minute walking distance in the combined treatment group was longer than that in the other groups(P<0.05).At 9 days after treatment,the left ventricular ejection fraction(LVEF)in the combined treatment group was higher than that in the other groups(P<0.05),and the level of N-terminal B-type natriuretic peptide(NT-proBNP)in the combined treatment group was lower than that in the other groups(P<0.05).No significant difference was found in the comparison of the o ccurrence of adverse reactions among the four groups(P>0.05).Conclusion The combination of levosimendan and rhBNP in the treatment of patients with acute heart failure is superior to traditional treatment and monotherapy in early clinic al improvement,and dose not increase the incidence of adverse reactions.