重组人脑利钠肽治疗射血分数保留心力衰竭患者的疗效

Efficacy of recombinant human brain natriuretic peptide in the treatment of patients with heart failure with preserved ejection fraction

目的:探讨重组人脑利钠肽治疗射血分数保留心力衰竭患者的疗效和安全性,以及患者用药后sST2及N末端B型利钠肽原(NT-proBNP)水平变化。方法:选取包头市第四医院2020年2月-2022年2月收治射血分数保留心力衰竭患者60例,按照是否接受重组人脑利钠肽治疗分为观察组(联合注射用重组人脑利钠肽治疗)30例及对照组(常规治疗)30例,观察两组治疗前、治疗72 h后,6 min步行试验(6 MWT)、血清sST2和NT-proBNP水平、超声心动图指标及临床疗效。结果:治疗72 h后,观察组6 MWT高于对照组,NT-proBNP水平低于对照组(P<0.05);治疗72 h后,观察组左心房容积指数(LAVI)低于对照组,左心室射血分数(LVEF)升高(P<0.05);观察组总有效率高于对照组(P<0.05);治疗72 h后,观察组血清sST2水平降低(P<0.05)。结论:注射用重组人脑利钠肽可改善射血分数保留心力衰竭患者的心肌功能,增加心脏排血量,减轻心肌细胞损伤,经sST2及NT-proBNP水平评估后确保有效,且临床用药安全性好,建议推广。

Objective:To investigate the efficacy and safety of recombinant human brain natriuretic peptide in the treatment of patients with heart failure with preserved ejection fraction,and the changes of sST2 and NT-proBNP levels after treatment.Methods:A total of 60 patients with heart failure with preserved ejection fraction were selected from February 2020 to February 2022 in Baotou Fourth Hospital.All patients were divided into observation group(combined with recombinant human brain natriuretic peptide for injection)and control group(conventional treatment)according to whether they received recombinant human brain natriuretic peptide treatment,with 30 patients in each group.The 6-minute walking test(6 MWT),serum sST2 and N-terminal B-type natriuretic peptide(NT-proBNP)levels,echocardiographic indicators and clinical efficacy of the two groups were observed before treatment and 72 hours after treatment.Results:After treatment,the 6 MWT of the observation group was higher than that of the control group,and the level of NT-proBNP was lower than that of the control group(P<0.05);the left atrial volume index(LAVI)in the observation group was lower than that in the control group,and the left ventricular ejection fraction(LVEF)was higher than that in the control group(P<0.05);the total effective rate of the observation group was higher than that of the control group(P<0.05);the serum sST2 level in the observation group was lower than that in the control group(P<0.05).Conclusion:Recombinant human brain natriuretic peptide for injection can improve myocardial function,increase cardiac output and reduce myocardial cell injury in patients with heart failure with preserved ejection fraction.It is effective after evaluation of sST2 and NT-proBNP levels,and the safety of clinical medication is good.