重组人脑利钠肽辅助急性心力衰竭急诊PCI的效果及对预后情况的影响

Effect of Recombinant Human Brain Natriuretic Peptide Assisted Emergency PCI for Acute Heart Failure

目的:观察重组人脑利钠肽(rhBNP)辅助急性心力衰竭急诊经皮冠脉介入术(PCI)的效果及对患者预后情况的影响。方法:选取2021年5月—2022年12月洛阳伊洛医院收治的106例急性心力衰竭患者作为研究对象,随机分为观察组和对照组,每组各53例。对照组仅实施急诊PCI治疗,观察组采用rhBNP辅助急诊PCI治疗,比较两组患者的血管内皮功能、心肌损伤、心功能改善情况以及心血管不良事件(MACE)、药物相关不良反应发生情况。结果:治疗后,观察组的6-酮-PGF1α(6-kelo-PGF1α)高于对照组,内皮素(ET-1)、一氧化氮(NO)、血清乳酸(LDH)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(CTnⅠ)均低于对照组;LVEF高于对照组,LVDD低于对照组;MACE发生率低于对照组,差异有统计学意义(t=3.522、3.111、2.930,2.814、3.138、3.686、3.468、3.793;χ^(2)=6.481,P<0.05)。两组患者的药物相关不良反应发生率比较,差异无统计学意义(χ^(2)=0.166,P>0.05)结论:rhBNP联合急诊PCI治疗急性心力衰竭能有效减轻患者的血管内皮损伤及心肌损伤,改善心功能、避免心室重构并降低MACE发生风险。未明显增加用药不良反应发生风险,安全性较高。

Objective:To observe the effect of recombinant human brain natriuretic peptide(rhBNP)assisted emergency percutaneous coronary intervention(PCI)in acute heart failure and its impact on patient prognosis.Methods:106 patients with acute heart failure were randomly divided into observation group and control group,with 53 patients in each group.Control group only received emergency PCI treatment,while observation group received rhBNP assisted emergency PCI treatment.The improvement of vascular endothelial function,myocardial injury,cardiac function,as well as the occurrence of cardiovascular adverse events(MACE)and drug-related adverse reactions were compared between the two groups.Results:After treatment,6-kelo-PGF1 in the observation group α was higher than the control group,ET-1,NO,LDH,CK-MB and CTnⅠ were all lower than the control group.LVEF was higher than the control group,while LVDD was lower than the control group.The incidence of MACE was lower than that of the control group,and the differences were statistically significant(t=3.522,3.111,2.930,2.814,3.138,3.686,3.468,3.793;χ^(2)=6.481;P<0.05).There was no statistically significant difference in the incidence of drug-related adverse reactions between the two groups(χ^(2)=0.166,P>0.05).Conclusion:The combination of rhBNP and emergency PCI in the treatment of acute heart failure can effectively reduce vascular endothelial and myocardial damage,improve cardiac function,avoid ventricular remodeling,and reduce the risk of MACE in patients.There is no significant increase in the risk of adverse drug reactions,and the safety is relatively high.