奥普力农联合冻干重组人脑利钠肽治疗重症监护病房重症心力衰竭患者的效果分析

recombinant human brain natriuretic peptide on patients with severe heart failure in intensive care unit

目的 探讨奥普力农联合冻干重组人脑利钠肽治疗重症监护病房(ICU)重症心力衰竭患者的效果。方法 选取2020年1月至2022年6月唐山中心医院ICU收治的114例重症心力衰竭患者为研究对象,按照随机数字表法分为对照组和观察组,各57例。对照组在常规治疗的基础上采用冻干重组人脑利钠肽治疗,观察组在对照组的基础上联合使用奥普力农治疗。2组患者均连续治疗3 d。比较2组治疗前(T0)、治疗48 h(T1)、治疗72 h(T2)的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、心功能改善情况,比较ICU住院时间、临床疗效、不良反应发生率及28 d病死率。结果 观察组T1、T2时点的APACHEⅡ评分、N末端B型脑钠肽前体水平均低于对照组,左心室射血分数、心输出量均高于对照组(均P<0.05)。观察组ICU住院时间短于对照组[(6.5±1.2)d比(7.3±1.4)d],治疗总有效率高于对照组[87.7%(50/57)比71.9%(41/57)](均P<0.05)。2组不良反应发生率、28 d病死率比较差异均无统计学意义(均P>0.05)。结论 奥普力农联合冻干重组人脑利钠肽治疗ICU重症心力衰竭患者临床效果显著,能够有效改善心力衰竭,缩短住院时间,降低APACHEⅡ评分。

Objective To investigate the effect of olprinone combined with lyophilized recombinant human brain natriuretic peptide on patients with severe heart failure in intensive care unit(ICU).Methods A total of 114 patients with severe heart failure admitted to ICU of Tangshan Central Hospital from January 2020 to June 2022 were selected as research objects.According to the random number table method,they were divided into the control group and the observation group,with 57 cases in each group.The control group was treated with lyophilized recombinant human brain natriuretic peptide on the basis of conventional treatment,while the observation group was treated with olprinone on the basis of the control group.Both groups of patients were treated continuously for 3 d.The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and cardiac function improvement were compared between the two groups before treatment,48 h and 72 h after treatment.The length of ICU stay,clinical efficacy,adverse reactions,and 28 d mortality were compared.Results The APACHEⅡscores and the levels of N-terminal pro-brain natriuretic peptide at 48 h and 72 h after treatment in the observation group were lower than those in the control group,and left ventricular ejection fraction and cardiac output were higher than those in the control group(all P<0.05).The length of ICU stay in the observation group was shorter than that in the control group[(6.5±1.2)d vs(7.3±1.4)d],and the total effective rate was higher than that in the control group[87.7%(50/57)vs 71.9%(41/57)](both P<0.05).There were no significant differences in the incidence of adverse reactions and 28 d mortality between the two groups(P>0.05).Conclusion The clinical effect of olprinone combined with lyophilized recombinant human brain natriuretic peptide in the treatment of ICU patients with severe heart failure is significant,which can effectively improve heart failure,shorten the length of hospital stay,and reduce APACHEⅡscores.