摘要
目的观察重组人脑利钠肽辅助治疗老年心力衰竭患者的临床疗效及其对心功能、炎性指标的影响。方法选取2015年4月-2016年4月辽宁省金秋医院心血管内科收治的心力衰竭患者82例作为研究对象,随机数字表法分为观察组41例和对照组41例,对照组给予常规抗心力衰竭治疗;观察组在对照组基础上联用重组人脑利钠肽,初始负荷剂量(1.5~2.0)μg/kg,3 min内静脉注射,然后以0.007 5μg·kg^(-1)·min^(-1)连续静脉泵入72 h,2组患者均连续治疗7 d;比较2组患者临床疗效;左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、每搏输出量(SV)、心脏指数(CI);血清脑钠肽(BNP)、C反应蛋白(CRP)含量、血肌酐(SCr)水平;记录不良反应。结果观察组总有效率为90.2%,显著高于对照组的73.2%(X^2=3.998,P=0.046);与治疗前比较2组患者治疗后LVEF明显提高,LVESD、BNP、CRP、SCr显著降低(t=10.411、4.710、34.623、5.942、3.128、6.593、1.761、19.126、3.732、1.768,P均<0.05),而LVEDD、SV、CI无明显变化(t=1.089、0.624、1.454、1.391、0.386、0.860,P均>0.05);观察组LVEF、LVESD、BNP、CRP、SCr改善程度明显优于对照组(t=4.029、3.047、25.666、3.893、1.738,P均<0.05);2组患者治疗期间发生体位性低血压、腹痛、头痛、转氨酶升高、血钾升高等不良反应发生率比较,差异均无统计学意义(X^2=1.075、0.503、0.193、0.889、0.889,P均>0.05)。结论重组人脑利钠肽辅助治疗老年心力衰竭患者能提高临床效果,改善心功能,减轻肾功能损伤和炎性反应,安全可靠,有利于患者的康复,值得临床推广应用。
Objective To observe the clinical efficacy and changes in heart function , BNP, SCr, CRP of elderly pa-tients with heart failure in treatment with recombinant human brain natriuretic peptide .Methods Eighty-two cases of patients with heart failure in Liaoning Jinqiu Hospital internal medicine department were selected , and they were divided into the ob-servation group （41 cases） and control group （41 cases）.The patients of control group were treated with conventional thera-py.On the basis of control group , the patients of observation group were treated with recombinant human brain natriuretic pep -tide （ initial loading dose （1.5 -2.0） μg /kg, intravenously within 3min, then 0.007 5μg.kg-1 .min-1 continuous intrave-nous infusion for 72h）.The patients of two groups were all treated for 7 days.Compare the clinical efficacy, adverse events and changes of the levels of left ventricular ejection fraction （LVEF）, left ventricular end systolic diameter （LVESD）, left ventricular end diastolic diameter （ LVEDD ） , stroke volume （ SV ） , cardiac index （ CI ） , serum brain natriuretic peptide （BNP）, C reactive protein （CRP） content, serum creatinine （SCr） of the two groups.Results After the appropriate treat-ment, the patients of the observation group got a total effective rate of 90.2%, which was significantly better than the 73.2%of the control group （χ2 =3.998, P =0.046）; In the terms of LVEF, LVESD, BNP, CRP and SCr, the patients of two groups were all significantly improved than before （ t =10.411, t =4.710, t =34.623, t =5.942, t =3.128, t =6.593, t =1.761, t =19.126, t =3.732, t =1.768, all P 〈0.05）, and the patients of the observation group got more significant improvement （ t =4.029, t =3.047, t =25.666, t =3.893, t =1.738, all P 〈0.05）;In the terms of LVEDD, SV, CI,＆nbsp;there were no significant changes than before in both two groups （ t =1.089, t =0.624, t =1.454, t =1.391, t =0.386, t=0.860, t =0.837, t =0.571, t =0.512, all P 〉0.05）;There were orthostatic hypotension, abdominal pain, headache, elevated aminotransferases , elevated serum potassium and other adverse reactions occurred in both two groups during the treat -ment, and there were no statistically significant between the two groups （χ2 =1.075,χ2 =0.503,χ2 =0.193,χ2 =0.889,χ2 =0.889, all P 〉0.05）.Conclusion Recombinant human brain natriuretic peptide in adjuvant therapy can improve the clinical effect of elderly patients with heart failure , improve heart function , reduce the renal injury and inflammatory reaction , safe and reliable , is conducive to the rehabilitation of patients , is worthy of clinical application .
出处
《疑难病杂志》
CAS
2017年第1期10-13,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
老年
心力衰竭
重组人脑利钠肽
心功能
Elderly
Heart failure
Recombinant human brain natriuretic peptide
Heart function
作者简介
通信作者：李悦，E—mail：grfdbbf@163．com.
