重组人脑利钠肽对急性失代偿性心力衰竭的疗效及相关指标的影响探讨

Efficacy of recombinant human brain natriuretic peptide on acute decompensated heart failure and its influence on related indicators

目的观察重组人脑利钠肽(rhBNP)对急性失代偿性心力衰竭的疗效及相关指标的影响。方法78例急性失代偿性心力衰竭患者,根据治疗方案差异分成对照组与观察组,每组39例。对照组采取常规治疗,观察组在对照组基础上加用重组人脑利钠肽治疗。比较两组治疗前后临床症状评分、炎性介质水平、血管内皮功能、心功能指标及生存质量。结果治疗后,两组呼吸困难、下肢水肿、入睡困难、喘息不止、颈静脉怒张评分较治疗前更低,且观察组呼吸困难、下肢水肿、入睡困难、喘息不止、颈静脉怒张评分分别为(1.05±0.26)、(1.43±0.25)、(0.77±0.21)、(1.51±0.45)、(1.29±0.62)分,较对照组的(2.52±0.89)、(2.31±0.67)、(1.07±0.38)、(2.12±0.36)、(2.31±0.72)分更低(P<0.05)。治疗后,两组肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平较治疗前更低,且观察组肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平分别为(0.43±0.15)pg/L、(8.86±1.51)pg/ml、(8.10±1.15)mg/L,较对照组的(0.61±0.11)pg/L、(10.51±1.62)pg/ml、(10.32±1.22)mg/L更低(P<0.05)。治疗后,两组一氧化氮、内皮素-1水平较治疗前更低,且观察组一氧化氮水平(53.81±7.92)μmol/L、内皮素-1水平(40.91±2.30)ng/L较对照组的(60.46±6.42)μmol/L、(52.16±3.63)ng/L更低(P<0.05)。两组治疗后左心室射血分数、心输出量、心脏指数较治疗前更高,左心室舒张末期内径、左心室收缩末期内径较治疗前更小,且观察组左心室射血分数、心输出量、心脏指数较对照组更高,左心室舒张末期内径、左心室收缩末期内径较对照组更小(P<0.05)。两组治疗后生理、心理、社会关系、环境评分较治疗前更高,且观察组较对照组更高(P<0.05)。结论采用重组人脑利钠肽治疗急性失代偿性心力衰竭效果显著,其能够改善患者临床相关症状及血管内皮功能,有助于心功能早日恢复至健康状态。

Objective To observe the efficacy of recombinant human brain natriuretic peptide(rhBNP)on acute decompensated heart failure and its influence on related indicators.Methods 78 patients with acute decompensated heart failure were divided into a control group and an observation group based on different treatment plans,with 39 cases in each group.The control group received conventional treatment,and the observation group was treated with recombinant human brain natriuretic peptide on the basis of the control group.The clinical symptom score,inflammatory mediator level,vascular endothelial function,cardiac function and quality of life were compared between the two groups before and after treatment.Results After treatment,the scores of dyspnea,lower limb edema,difficulty in sleeping,wheezing and jugular vein distention were lower than those before treatment;the scores of dyspnea,lower limb edema,difficulty in sleeping,wheezing and jugular vein distention in the observation group were(1.05±0.26),(1.43±0.25),(0.77±0.21),(1.51±0.45)and(1.29±0.62)points,which were lower than(2.52±0.89),(2.31±0.67),(1.07±0.38),(2.12±0.36)and(2.31±0.72)points in the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α,interleukin-6 and hypersensitive C-reactive protein in both groups were lower than those before treatment;the levels of tumor necrosis factor-α,interleukin-6 and hypersensitive C-reactive protein in the observation group were(0.43±0.15)pg/L,(8.86±1.51)pg/ml and(8.10±1.15)mg/L,which were lower than(0.61±0.11)pg/L,(10.51±1.62)pg/ml and(10.32±1.22)mg/L in the control group(P<0.05).After treatment,both groups had higher nitric oxide levels and endothelin-1 levels than those before treatment;the observation group had nitric oxide level of(53.81±7.92)μmol/L and endothelin-1 level of(40.91±2.30)ng/L,which were lower than(60.46±6.42)μmol/L and(52.16±3.63)ng/L in the control group(P<0.05).After treatment,the left ventricular ejection fraction,cardiac output,and cardiac index in both groups were higher than those before treatment,and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter were smaller than those before treatment;the left ventricular ejection fraction,cardiac output,cardiac index in the observation group were higher than those before treatment,and the left ventricular end-diastolic diameter,left ventricular end-systolic diameter were smaller than those in the control group(P<0.05).After treatment,the physical,psychological,social relationship,and environmental scores in both groups were higher than those before treatment,and the observation group was higher than the control group(P<0.05).Conclusion Recombinant human brain natriuretic peptide is effective in the treatment of acute decompensated heart failure,which can improve the clinical symptoms and vascular endothelial function of patients,and help to restore the heart function to a healthy state early.