冻干重组人脑利钠肽联合呋塞米对难治性心力衰竭患者血流动力学、心肌损伤及肾功能的影响

Effects of freeze-dried recombinant human brain natriuretic peptide combined with furosemide on hemodynamics,myocardial injury,and renal function in patients with refractory heart failure

目的:探讨难治性心力衰竭(RHF)患者采用冻干重组人脑利钠肽联合呋塞米治疗,对其血流动力学、心肌损伤及肾功能的影响。方法:选择200例RHF患者为研究对象,按照治疗方案不同分为对照组(n=113)和观察组(n=87)。两组均给予基础对症治疗,对照组加用呋塞米治疗;观察组在呋塞米治疗的基础上联合冻干重组人脑利钠肽治疗。比较两组患者治疗两周后的临床疗效、血流动力学参数、心肌损伤指标及肾功能指标。结果:治疗两周后,观察组患者治疗有效率高于对照组(P<0.05);患者平均动脉压、中心静脉压等血流动力学参数,血清氨基末端脑钠肽(NT-proBNP)、心肌肌钙蛋白T(cTnT)等心肌损伤指标水平均下降,且观察组低于对照组(P<0.05);两组患者尿素氮(BUN)、血清肌酐(Scr)均降低,但两组间差异无统计学意义(P>0.05);肾小球滤过率(GFR)升高,且观察组高于对照组(P<0.05)。结论:冻干重组人脑利钠肽联合呋塞米有利于提升RHF治疗效果,改善血流动力学指标,缓解心肌损伤,保护肾功能。

Objective:To investigate the effects of lyophilized recombinant human brain natriuretic peptide combined with furosemide on hemodynamics,myocardial injury and renal function in patients with refractory heart failure(RHF).Methods:200 patients with RHF were divided into control group(n=113)and observation group(n=87)according to different treatment regimens.Both groups were given basic symptomatic treatment.The control group was treated with furosemide,and the observation group was treated with furosemide combined with lyophilized recombinant human brain natriuretic peptide.The clinical efficacy,hemodynamic parameters,myocardial injury indexes and renal function indexes of the two groups were compared after 2 weeks of treatment.Results:After 2 weeks of treatment,the effective rate of the observation group was higher than that of the control group(P<0.05).The hemodynamic parameters such as mean arterial pressure and central venous pressure,and the levels of myocardial injury indexes such as serum amino-terminal brain natriuretic peptide(NT-proBNP)and cardiac troponin T(cTnT)in the observation group were lower than those in the control group,and the two groups were lower than those before treatment(P<0.05).Both groups of patients had lower levels of urea nitrogen(BUN)and serum creatinine(Scr)compared to before treatment,but there was no statistically significant difference between the two groups(P>0.05).The glomerular filtration rate(GFR)increased,and the observation group was higher than the control group(P<0.05).Conclusion:The combination of freeze-dried recombinant human brain natriuretic peptide and furosemide is beneficial for enhancing the therapeutic effect of RHF,improving hemodynamic indicators,alleviating myocardial injury,and having a certain protective effect on renal function.