新活素联合速尿治疗急性心肌梗死合并心力衰竭患者心功能及血气指标的改善效果

Effect of recombinant human brain natriuretic peptide combined with furosemide in improvement of cardiac function and blood gas indicators in patients with acute myocardial infarction complicated with heart failure

目的探讨新活素联合速尿对急性心肌梗死(AMI)合并心力衰竭患者心功能及血气指标的改善效果。方法选取AMI合并心力衰竭患者152例,通过随机抽签法分为对照组和观察组,每组76例,对照组应用速尿治疗,观察组联合应用新活素和速尿进行治疗。观察2组治疗前后的心功能、血气指标变化,比较治疗效果及用药期间的不良反应情况。结果2组治疗后的心功能指标及动脉血气指标均较治疗前改善,并且观察组的左心射血分数(LVEF)、血氧饱和度(S_(a)O_(2))及动脉血氧分压[p_(a)(O_(2))]水平更高,左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及动脉血二氧化碳分压[p_(a)(CO_(2))]水平均更低,差异有统计学意义(P<0.05)。观察组治疗后的血肌酐(SCr)、肌酸激酶同工酶(CK-MB)水平下降,肌红蛋白(Mb)水平升高,且观察组优于对照组,差异有统计学意义(P<0.05)。观察组的治疗总有效率为90.79%,高于对照组的60.53%,差异有统计学意义(P<0.05)。2组用药治疗期间的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论AMI合并心力衰竭的临床治疗联用新活素与速尿对心功能、血气指标有显著改善效果,治疗效果确切,且不会增加不良反应,安全性好。

Objective To investigate the improvement effect of recombinant human brain natriuretic peptide(rhBNP)combined with furosemide on cardiac function and blood gas indicators in patients with acute myocardial infarction(AMI)complicated with heart failure.Methods A total of 152 patients with AMI complicated with heart failure were selected and randomly divided into control group and observation group using a random drawing method,with 76 patients in each group.The control group was treated with furosemide,while the observation group received a combination therapy of rhBNP and furosemide.Changes in cardiac function and blood gas indicators before and after treatment were observed in both groups,and the therapeutic effects and adverse reactions during medication were compared.Results Cardiac function indicators and arterial blood gas indicators in both groups were significantly improved after treatment compared with those before treatment.Additionally,the left ventricular ejection fraction(LVEF),blood oxygen saturation(S_(a)O_(2)),and partial pressure of oxygen[p_(a)(O_(2))]levels were higher,while the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),and partial pressure of carbon dioxide[p_(a)(CO_(2))]levels were lower in the observation group compared to the control group(P<0.05).After treatment,the levels of serum creatinine(SCr)and creatine kinase isoenzyme(CK-MB)decreased,and the level of myoglobin(Mb)increased significantly in the observation group,which were better than those in the control group(P<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group(90.79%versus 60.53%,P<0.05).There was no statistically significant difference in the total incidence of adverse reactions during medication between the two groups(P>0.05).Conclusion The clinical treatment of AMI complicated with heart failure using a combination of rhBNP and furosemide has a significant improvement effect on cardiac function and blood gas indicators,with a definitive therapeutic effect and no increase in adverse reactions,thus it is better in safety.