摘要
目的探讨冻干重组人脑利钠肽联用参附注射液治疗急性左心衰竭(ALHF)的临床价值。方法按照治疗方案将空军军医大学第二附属医院112例ALHF患者(2017年1月至2019年2月)分为观察组与对照组,每组56例。积极治疗原发病、合并症及常规治疗措施基础上,对照组给予冻干重组人脑利钠肽治疗,观察组再联合参附注射液治疗,两组均于治疗3 d后评价相关指标。对比两组临床疗效、治疗前后心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)]参数及血清学指标[人半乳糖凝集素3(Gal-3)、脑钠素N端前体肽(NT-proBNP)]水平改善情况、心脏不良事件发生率、治疗安全性。结果①临床疗效:观察组治疗总有效率92.86%(52/56)高于对照组78.57%(44/56)(P<0.05);②心功能:治疗后两组LVEDD、LVEF、LVFS均较治疗前改善,且观察组LVEDD小于对照组,LVEF、LVFS高于对照组(P均<0.05);③血清学指标:治疗后两组血清Gal-3及NT-proBNP水平均较治疗前降低,且观察组低于对照组(P均<0.05);④心脏不良事件:两组均无死亡病例,观察组心脏不良事件发生率3.57%(2/56)低于对照组14.29%(8/56)(P<0.05);⑤安全性:治疗期间观察组不良反应发生率19.64%(11/56)与对照组17.86%(10/56)比较无显著差异(P>0.05)。结论冻干重组人脑利钠肽基础上给予ALHF参附注射液联合治疗,效果显著,可有效改善患者心功能,下调血清Gal-3、NT-proBNP表达,降低心脏不良事件发生风险,且具有一定安全性。
Objective To investigate the clinical value of lyophilized recombinant human brain natriuretic peptide combined with Shenfu injection in the treatment of acute left heart failure(ALHF).Methods According to the treatment plan,112 patients with ALHF in our hospital(January 2017 to February 2019)were divided into observation group and control group,56 cases in each group.On the basis of active treatment of primary disease,comorbidities and conventional treatment measures,the control group was treated with lyophilized recombinant human brain natriuretic peptide,and the observation group was treated with Shenfu injection.The two groups were evaluated after 3 days of treatment.Comparison of clinical efficacy,cardiac function index before and after treatment[LVDHD,left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS)],parameters and serological indicators[human galactose agglutination Improvement of the level of 3(Gal-3)and N-terminal pro-brain natriuretic peptide(NT-proBNP)],the incidence of adverse cardiac events,and the safety of treatment.Results①Clinical efficacy:The total effective rate of observation group was 92.86%(52/56)higher than that of control group(78.57%(44/56)(P<0.05);②cardiac function:LVEDD,LVEF after treatment LVFS was improved compared with before treatment,and the LVEDD in the observation group was lower than that in the control group,LVEF and LVFS were higher than those in the control group(P<0.05).③Serological indicators:serum Gal-3 and NT-proBNP levels in the two groups after treatment Reduced before treatment,and the observation group was lower than that of the control group(P<0.05);④Cardiac adverse events:no deaths in the two groups,the incidence of cardiac adverse events in the observation group was 3.57%(2/56)lower than that of the control group.14.29%(8/56)(P<0.05);⑤Safety:The incidence of adverse reactions in the observation group was 19.64%(11/56)and there was no significant difference compared with the control group 17.86%(10/56)(P>0.05).Conclusion Lyophilized recombinant human brain natriuretic peptide combined with ALHF Shenfu injection is effective,which can effectively improve the heart function,down-regulate the expression of serum Gal-3 and NT-proBNP,reduce the risk of adverse cardiac events,and have certain safety.
作者
康黎
张莹
高砚丽
KANG Li;ZHANG Ying;GAO Yan-li(Department of Geriatrics,The Second Affiliated Hospital of Air Force Military Medical University,Xi′an 710038,China)
出处
《延安大学学报（医学科学版）》
2020年第3期38-42,共5页
Journal of Yan'an University:Medical Science Edition
作者简介
康黎(1982-),女,陕西西安人,主治医师。研究方向:老年心血管疾病;通信作者:高砚丽(1984-),女,陕西靖边人,硕士,主治医师。研究方向:老年心血管疾病。E-mail:158899281@qq.com。
