重组人脑利钠肽治疗老年患者急性心肌梗死泵衰竭的疗效  

Therapeutic efficacy of recombinat human brain natriuretic peptide on elderly acute myocardial infarction with heart failure

作　　者：姜胜[1] 周宁[1] 王庸晋[1] 王治平[1] 王少黎[1] 李启富[1] 

机构地区：[1]长治医学院附属和平医院心内科,山西长治046000

出　　处：《中华老年医学杂志》2012年第8期666-668,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨重组人脑利钠肽（rhBNP）治疗老年急性心肌梗死泵衰竭患者的效果。方法选取老年急性心肌梗死患者63例，分为治疗组和对照组，治疗组在常规治疗基础上静脉泵人重组人脑利钠肽，对照组在常规治疗基础上泵人硝酸甘油，均应用3～5d。观察两组患者治疗前后呼吸困难缓解比率、心率、血氧饱和度变化、左室射血分数（LVEF）、左室舒张末容积（LVDD）、血浆白介素6（IL-6）和超敏C反应蛋白（hsCRP）水平。结果治疗组总有效率79．3％（23／29），对照组总有效率64．7％（22／34）（P=0．017），治疗组呼吸困难症状缓解优于对照组（P〈0．05）；心率、血氧饱和度、LVEF、hsCRP、IL-6治疗组治疗前分别为[（120±11）次／min、（78士6）％、（28±32）％、（25．78土2．44）mg／L、（40．74±5．43）μg／L]，治疗后分别为[（89±9）次／min、（97±6）％、（43±20）％、（12．78±2．54）mg／L、（28．45±2．34）μg／L]，治疗前后比较均P〈0．05；心率、血氧饱和度、LVEF、hsCRP、IL-6对照组治疗前分别为[（117±8）次／min、（80±8）％、（29±31）％、（21．44±1．33）mg／L、（41．87±5．46）μg／L3，治疗后分别为[（109士10）次／min、（34±18）％、（43±20）％、（17．63±1．62）mg／L、（36．56±3．02）μg／L3，治疗组在降低心率、hsCRP、IL-6及提高LVEF优于对照组（均P〈0．05）。结论重组人脑利钠肽治疗老年急性心肌梗死泵衰竭效果显著。Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide （rhBNP） in the treatment of acute myocardial infarction （AMI） with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy （29 cases） and control （34 cases） groups. Besides routine treatment, the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin. Both drugs were administered for 3-5 days. The dyspnea remission rates after treatment were recorded. At the same time, heart rates and blood oxygen saturation, left ventricular ejection fraction （LVEF） and left ventricular end diastolic volume （LVDD）, serum interleukin 6 （IL-6） and high sensitivity C reactive protein （hsCRP） were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 %（23/29）in therapy group and 64.7% （22/34）in control group（P=0. 017）. The dyspnea remission rate was better in therapy group than in control group （P（0.05）. The heart rate, blood oxygen saturation, LVEF, hsCPR and IL-6 in therapy group were [（120＋11）times/min,（78±6）%,（28±32）%,（25.78±2.44） mg/L,（40.74±5.43）μg/L] before treatment, and after treatment [ （ 89 ± 9） times/min, （ 97 ± 6） %, （ 43± 20） %, （ 12.78 ± 2.54） mg/L,（28.45±2.34） μg/L] （all P〈0. 05）. The above indexes in control group were [（117＋8） times/min, （80±8） %, （29±31） %, （21.44±1.33） rag/L, （41.87± 5.46） μg/L] before treatment , and after treatment（109±10） times/rain, （34±18） %, （43±20） %, （17.63±1.62） mg/L, （36.56± 3.02） vg/L]. The heart rate and the levels of IL-6 and hsCPR were reduced, blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.

关 键 词：脑利钠肽 急性心肌梗死 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病]