新活素与硝普钠联合治疗慢性心力衰竭
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摘要
【目的】研究新活素与硝普钠治疗慢性心力衰竭(chronic heart failure,CHF)的临床效果,旨在寻求至治疗CHF更佳的临床药物。【方法】采用随机平行对照方法,将2014年10月至2016年1月在我院心内科进行诊治的108例CHF患者分为观察组和对照组,每组54例。观察组静脉泵入新活素[负荷量1.5μg/kg,维持量0.01μg·(kg·min)~(-1)],对照组静脉泵入硝普钠[50~100μg/min]。观察比较两组临床疗效及治疗前后左室射血分数(left ventricular ejection fraction,LVEF)及N端脑钠肽前体N端脑钠肽激素原(N-terminal B-type natriuretic peptide,NT-proBNP)差值变化。【结果】两组患者治疗后显示,观察组总有效率90.7%(49/54),明显优于对照组总有效率68.5%(37/54)(P<0.05),差异有统计学意义,观察组治疗前后NT-proBNP差值及LVEF差值明显优于对照组(P<0.05),差异有统计学意义。【结论】新活素可以短期内明显改善慢性充血性心衰患者的临床症状体征、提高左心室射血分数,降低NT-proBNP、对改善心功能有积极作用。
【Objective】To explore the clinical efficacy of lyophilized recombinant human brain natriuretic peptide and sodium nitrate in the treatment of chronic heart failure and find better clinical therapeutic drugs for CHF.【Methods】 According to the randomized parallel controlled method, 108 patients with CHF in the department of cardiology of our hospital from Oct. 2014 to Jan. 2016 were selected and divided into observation group and control group(54 cases per group). The patients in the observation group received intravenous infusion of lyophilized recombinant human brain natriuretic peptide. Those in the control group received intravenous infusion of sodium nitrate. The changes of clinical efficacy and related indicators were compared between the two groups.【Results】After the treatment, the total efficiency in the observation group(90.7%, 49/54) was significantly better than that in the control group(68.5.%, 37/54)(P<0.05). The difference was statistically significant. The difference of NT-proBNP and LVEF in the observation group before and after the treatment was more significant than that in the control group(P<0.05).【Conclusion】Lyophilized recombinant human brain natriuretic peptide can significantly improve the clinical symptoms and signs in patients with chronic congestive heart failure in a short term, increase left ventricular ejection fraction and reduce NT-proBNP. It has a positive effect on improving cardiac functions.
【Objective】To explore the clinical efficacy of lyophilized recombinant human brain natriuretic peptide and sodium nitrate in the treatment of chronic heart failure and find better clinical therapeutic drugs for CHF.【Methods】 According to the randomized parallel controlled method, 108 patients with CHF in the department of cardiology of our hospital from Oct. 2014 to Jan. 2016 were selected and divided into observation group and control group(54 cases per group). The patients in the observation group received intravenous infusion of lyophilized recombinant human brain natriuretic peptide. Those in the control group received intravenous infusion of sodium nitrate. The changes of clinical efficacy and related indicators were compared between the two groups.【Results】After the treatment, the total efficiency in the observation group(90.7%, 49/54) was significantly better than that in the control group(68.5.%, 37/54)(P<0.05). The difference was statistically significant. The difference of NT-proBNP and LVEF in the observation group before and after the treatment was more significant than that in the control group(P<0.05).【Conclusion】Lyophilized recombinant human brain natriuretic peptide can significantly improve the clinical symptoms and signs in patients with chronic congestive heart failure in a short term, increase left ventricular ejection fraction and reduce NT-proBNP. It has a positive effect on improving cardiac functions.
引文
[1]王怀诚,韦生坤.联合硝普钠、多巴胺微量泵治疗肺结核肺心病心衰疗效观察[J].海峡药学,2010,22(10):103-105.
[2]Abraham WT,Lowes BD,Ferguson DA,et al.Systemic hemodynamic,neurohormonal,and renal effects of a steadystate infusion of human brain natriuretic peptide in patients with hemodynamically decompensated heart failure[J].J Card Fail,1998,4(1):37-44.
[3]胡大一,马长生.心脏病学实践2010:规范化治疗[M].北京:人民卫生出版社,2010:1-598.
[4]Bernjak A,Clarkson PB,Mc Clintock PV,et al.Low-frequency blood flow oscillations in congestive heart failure and after beta1-blockade treatment[J].Microvasc Res,2008,76(3):224-232.
[5]Hildebrandt P,Collinson PO.Amino-terminal pro-B-type natriuretic peptide testing to assist the diagnostic evaluation of heart failure in symptomatic primary care patients[J].Am J Cardiol,2008,101(3A):25-28.
[6]中华医学会心血管病学分会中华心血管病杂志编辑委员会.急性心力衰竭诊断和治疗指南(2)[J].中国医刊,2010,45(9):70-75.
[7]刘春辉,卢均坤,李奕红,等.新活素对急性心肌梗死合并心力衰竭患者心肌重塑的影响[J].黑龙江医药科学,2010,33(5):63-64.
[2]Abraham WT,Lowes BD,Ferguson DA,et al.Systemic hemodynamic,neurohormonal,and renal effects of a steadystate infusion of human brain natriuretic peptide in patients with hemodynamically decompensated heart failure[J].J Card Fail,1998,4(1):37-44.
[3]胡大一,马长生.心脏病学实践2010:规范化治疗[M].北京:人民卫生出版社,2010:1-598.
[4]Bernjak A,Clarkson PB,Mc Clintock PV,et al.Low-frequency blood flow oscillations in congestive heart failure and after beta1-blockade treatment[J].Microvasc Res,2008,76(3):224-232.
[5]Hildebrandt P,Collinson PO.Amino-terminal pro-B-type natriuretic peptide testing to assist the diagnostic evaluation of heart failure in symptomatic primary care patients[J].Am J Cardiol,2008,101(3A):25-28.
[6]中华医学会心血管病学分会中华心血管病杂志编辑委员会.急性心力衰竭诊断和治疗指南(2)[J].中国医刊,2010,45(9):70-75.
[7]刘春辉,卢均坤,李奕红,等.新活素对急性心肌梗死合并心力衰竭患者心肌重塑的影响[J].黑龙江医药科学,2010,33(5):63-64.