重组人脑利钠肽在急性心肌梗死后心力衰竭治疗中的应用  

Application of recombinant human brain natriuretic peptide in the treatment of heart failure after acute myocardial infarction

作　　者：侯舒心[1] 卢英民[1] 黄达民[1] 罗晓菡[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院心内科,上海202150

出　　处：《世界临床药物》2014年第12期727-731,共5页World Clinical Drug

摘　　要：目的探索重组人脑利钠肽(rh BNP)在急性心肌梗死(AMI)后心力衰竭(HF)治疗中的应用价值。方法纳入我院2013年1月-2014年8月期间收治的64例AMI后HF患者,随机分为治疗组和对照组,每组各32例。对照组予常规抗心衰治疗,治疗组在此基础上加用rh BNP,以临床疗效及治疗前后N-末端脑利钠肽前体(NT-pro BNP)、C反应蛋白(CRP)、左心室射血分数(LVEF)和左心室舒张末内径(LVDD)等指标的变化评价联用rh BNP的价值。结果治疗后,治疗组总有效率(87.5%)明显高于对照组(65.6%),组间差异有统计学意义(P<0.05);两组LVEF均明显升高(P<0.05),且治疗组LVEF[(55.40±9.40)%]显著高于对照组[(50.60±8.40)%];两组患者LVDD、NT-pro BNP和CRP指标均显著降低(P<0.05),且治疗组LVDD、NT-pro BNP、CRP[分别为(48.10±6.20)mm、(3 082.41±258.92)pg/ml和(3.02±0.56)mg/L]相比对照组LVDD、NT-pro BNP、CRP[(51.00±6.40)mm、(3 746.58±469.58)pg/L和(3.24±0.75)mg/L]下降更为显著,组间差异均有统计学意义(P<0.05)。结论常规抗心衰治疗方案联合静脉用rh BNP治疗AMI后HF疗效好且安全,值得进一步研究和推广。Objective To explore the application effect of recombinant human brain natriuretic peptide （rhBNP） in the treatment of heart failure （HF） after acute myocardial infarction （AMI）. Methods Sixty-four patients with HF after AMI from January 2013 to August 2014 were randomly divided into control group and treatment group as 32 cases for each group. The control group was given the conventional treatment, while the treatment group was added with rhBNP. The clinical efficacy, left ventricular ejection fraction （LVEF）, left ventricular and diastolic diameter （LVDD）, plasma C-reactive protein （CRP） and NT-proBNP were compared between two groups. Results The total effective rate of the treatment group （87.5%） was significantly higher than that of the control group （65.6%, P〈 0.05）. After treatment the LVEF of both two groups was increased significantly （P〈0.05）. LVEF of the treatment group （55.44±9.4 %） was significantly higher than that （50.6 4±8.4%） of the control group （P〈0.05）. However, the LVDD, NT-proBNP and CRP of both two groups were decreased significantly （P〈0.05）. LVDD [ （48.14±6.2）mm], NT-proBNP[ （3082.41±258.92）pg/ml] and plasma CRP[ （3.024±0.56） mg/L] of the treatment group were significantly lower than those [ （51.0±6.4 ） ram, （3 746.58±469.58） pg/ml and （3.24±0.75）rag/L] of the control group （P〈 0.05）. Conclusion rhBNP has definite clinical effect in the treatment of HF after AMI and has the advantages of safety and efficiency

关 键 词：重组人脑利钠肽 急性心肌梗死 心力衰竭 心肌重塑 

分 类 号：R542.22[医药卫生—心血管疾病]