冻干重组人脑利钠肽联合呋塞米治疗老年缺血性心肌病合并心力衰竭的效果

Therapeutic effect of freeze-dried recombinant human brain natriuretic peptide combined with furosemide on ischemic cardiomyopathy complicated by heart failure in elderly patients

目的分析冻干重组人脑利钠肽联合呋塞米治疗老年缺血性心肌病合并心力衰竭的临床效果。方法队列研究。抽取2022年6月至2023年10月濮阳市人民医院收治的74例老年缺血性心肌病合并心力衰竭患者为研究对象,根据治疗方案分为单一组与联合组,每组37例。单一组采用呋塞米及基础干预,联合组在单一组的治疗基础上采用冻干重组人脑利钠肽。比较两组临床疗效;比较两组治疗前后心功能超声指标[左室射血分数(LVEF)、左室收缩末期容积(LVESV)]、心室重构指标[左室后壁厚度(LVPWT)、心室间隔收缩末期厚度(IVSS)]、心功能评分、呼吸困难评分;比较两组治疗后心功能相关生化指标[氨基末端脑钠肽(NT-proBNP)、血肌酐、血钾、血钠]水平。结果联合组总有效率(94.59%,35/37)高于单一组(75.68%,28/37),P<0.05。治疗后,联合组LVEF高于单一组,LVESV、LVPWT、IVSS低于单一组(P<0.05)。治疗后,联合组NT-proBNP、血肌酐、血钠水平低于单一组,血钾水平高于单一组(P<0.05)。治疗后,联合组心功能评分、呼吸困难评分均低于单一组(P均<0.05)。结论冻干重组人脑利钠肽联合呋塞米治疗老年缺血性心肌病合并心力衰竭的效果显著,可抑制心室重构,调节心功能相关生化指标,改善心功能。

Objective To analyze the effect of freeze-dried recombinant human brain natriuretic peptide combined with furosemide in the treatment of ischemic cardiomyopathy complicated by heart failure in elderly patients.Methods A total of 74 elderly patients with ischemic cardiomyopathy complicated by heart failure treated in Puyang People’s Hospital from June 2022 to October 2023 were selected as study objects of the cohort study.According to therapeutic plans,the selected patients were divided into the single group and the combined group,with 37 cases in each group.The single group was treated with furosemide based on routine treatment,and the combined group was treated with freeze-dried recombinant human brain natriuretic peptide based on the treatment of the single group.The treatment efficacy of the two groups were compared.The ultrasound indexes of cardiac function,including left ventricular ejection fraction(LVEF)and left ventricular end-systolic volume(LVESV),ventricular remodeling indexes,including left ventricular posterior wall thickness(LVPWT)and interventricular septal thickness at end-systole(IVSS),cardiac function score and dyspnea score were compared between the two groups before and after treatment.The postoperative levels of related biochemical indicators of cardiac function,including N-terminal pro B-type natriuretic peptide(NT-proBNP),blood creatinine,blood potassium and blood sodium,were compared between the two groups.Results The total effective rate of the combined group was 94.59%(35/37),higher than the 75.68%(28/37)of the single group(P<0.05).After treatment,the combined group had higher level of LVEF,but had lower levels of LVESV,LVPWT and IVSS compared with the single group(P<0.05).After treatment,the levels of NT-proBNP,blood creatinine and blood potassium in the combined group were lower,while the level of blood sodium was higher compared with the single group(P<0.05).After treatment,the cardiac function score and dyspnea score of the combined group were lower than those of the single group(all P<0.05).Conclusions Freeze-dried recombinant human brain natriuretic peptide combined with furosemide has significant therapeutic effects in the treatment of ischemic cardiomyopathy complicated by heart failure in elderly patients,which can inhibit ventricular remodeling,regulate the expression of biochemical indicators related to cardiac function,and improve cardiac function.