左西孟旦联合新活素对慢性心力衰竭急性失代偿期患者的疗效

Curative effect of levosimendan combined with lyophilized recombinant human brain natriuretic peptide in patients with acute decompensated heart failure

目的探究左西孟旦联合新活素对慢性心力衰竭急性失代偿期(acute decompensated heart failure,ADHF)患者心功能、血清脑钠肽(brain natriuretic peptide,BNP)和肌钙蛋白Ⅰ(troponinⅠ,cTnⅠ)的影响。方法选取就诊的ADHF患者100例作为研究对象,随机分为观察组和对照组,每组50例。对照组给予左西孟旦治疗,观察组给予左西孟旦联合新活素治疗,比较2组治疗后的临床疗效、纠正心力衰竭时间、住院时间和不良反应,比较2组治疗前后左心室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastopc diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、24 h尿量、BNP、cTnⅠ和超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)。结果观察组的总有效率(96.00%)高于对照组(78.00%),P<0.05;观察组的心力衰竭纠正时间和住院时间均短于对照组(P<0.05);观察组LVEF水平高于对照组,LVEDD和LVESD水平低于对照组(P<0.05);观察组BNP、cTnⅠ和hs-CRP水平均低于对照组(P<0.05);观察组的不良反应发生率(6.00%)与对照组的不良反应发生率(8.00%)比较,差异无统计学意义(P>0.05)。结论左西孟旦联合新活素可提高ADHF患者的心功能,降低血清BNP、cTnⅠ的水平。

Objective To explore the effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide(Lrh-BNP)on cardiac function,serum brain natriuretic peptide(BNP)and cardiac troponin(cTnⅠ)in patients with acute decompensated heart failure(ADHF).Methods A total of 100 patients with ADHF were enrolled as the research objects.They were randomly divided into observation group(n=50)and control group(n=50).The control group was treated with levosimendan,while the observation group was treated with levosimendan combined with Lrh-BNP.The clinical curative effect,correction time of heart failure,hospitalization time and adverse reactions after treatment,the left ventricular ejection fraction(LVEF),left ventricular enddiastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),24 hours urine output,BNP,cTnⅠand high sensitivity C-reactive protein(hs-CRP)before and after treatment were compared between the 2 groups.Results The total response rate of observation group was higher than that of control group(96.00%vs.78.00%,P<0.05).The correction time of heart failure and hospitalization time in observation group were shorter than those in control group(P<0.05).The LVEF in observation group was higher than that in control group,while the LVEDD and LVESD were lower than those in control group(P<0.05).The levels of BNP,cTnⅠand hs-CRP in observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between observation group and control group(6.00%vs.8.00%,P>0.05).Conclusion Levosimendan combined with Lrh-BNP can improve cardiac function and reduce the levels of serum BNP and cTnⅠin ADHF patients.