摘要
目的探讨左西孟坦联合冻干重组人脑利钠肽治疗老年心力衰竭患者的临床效果。方法选取2015年1月至2018年1月我院诊治的80例老年心力衰竭患者作为研究对象,依据Excel 2007编写的随机数字表分为观察组和对照组各40例,两组患者均给予强心、利尿等基础治疗措施,观察组同时给予左西孟坦联合冻干重组人脑利钠肽治疗,对照组同时给予左西孟坦联合多巴酚丁胺治疗;对比两组患者治疗前后的左室舒张末期内经(LVEDD)、左室射血分数(LVEF)、心脏指数(CI)、每搏输出量(SV)、血清胱抑素C(Cys-C)、氨基末端脑钠肽前体(NT-proBNP)、平均动脉压(MAP)、肺毛细血管契压(PCWP)。结果治疗前,观察组和对照组患者的LVEDD、LVEF、CI、SV水平差异不具有统计学意义(P> 0.05);治疗后,观察组患者的LVEDD显著的低于对照组(P <0.05),观察组的LVEF、CI、SV测定值显著高于对照组(P <0.05);治疗前,观察组和对照组患者的血清Cys-C、NT-proBNP水平差异不具有统计学意义(P>0.05);治疗后,观察组患者的血清Cys-C、NT-proBNP水平显著的低于对照组(P <0.05);治疗前,观察组和对照组患者的MAP、PCWP水平差异不具有统计学意义(P> 0.05);治疗后,观察组患者的MAP、PCWP水平显著的低于对照组(P <0.05);观察组患者的不良反应发生率10.00%与对照组的5.00%差异不具有统计学意义(P> 0.05)。结论左西孟坦联合冻干重组人脑利钠肽治疗老年心力衰竭患者能显著的改善患者心功能、降低Cys-C、NT-proBNP水平,改善血流动力学指标。
Objective To investigate the clinical effects of levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in elderly patients with heart failure. Methods Eighty patients with heart failure diagnosed in our hospital from January 2015 to January 2018 were selected as subjects. According to the random number table prepared in Excel 2007, 40 patients in the experimental group and the control group were given. For basic treatments such as diuresis, the experimental group was treated with levosimtan combined with lyophilized recombinant human brain natriuretic peptide, and the control group was treated with levosimtan and dobutamine. The left ventricle of the two groups before and after treatment was compared. End-diastolic period(LVEDD), left ventricular ejection fraction(LVEF), cardiac index( CI), stroke volume(SV), serum cystatin C(Cys-C), amino terminal brain natriuretic peptide precursor(NT-proBNP), mean arterial pressure( MAP),pulmonary capillary pressure(PCWP). Results Before treatment, the differences of LVEDD, LVEF, CI and SV levels between the experimental group and the control group were not statistically significant(P > 0.05). After treatment, the LVEDD of the experimental group was significantly lower than that of the control group(P < 0.05).The LVEF, CI and SV values in the experimental group were significantly higher than those in the control group(P < 0.05). There was no significant difference in serum Cys-C and NT-proBNP levels between the experimental group and the control group before treatment(P > 0.05). After treatment, the serum levels of Cys-C and NT-proBNP in the experimental group were significantly lower than those in the control group(P < 0.05). Before treatment, the difference of MAP and PCWP levels between the experimental group and the control group was not statistically significant(P > 0.05). After treatment, the MAP and PCWP levels in the experimental group were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions in the experimental group was 10.00% and the difference between the control group and the control group was not statistically significant(P>0.05). Conclusions Levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in patients with senile heart failure can significantly improve cardiac function, reduce Cys-C, NT-proBNP levels, and improve hemodynamic parameters.
引文
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