应用NT-proBNP评价常规药物加心区交感神经阻滞对心衰治疗的有效性  

Evaluation Value of NT- proBNP to the Effectiveness of CSNB with Conventional Drugs in Patients with Chronic Heart Failure

作　　者：赵敏[1] 刘凤岐[1] 马丹[1] 周晋[1] 曲仁海[2] 李竹琴[3] 

机构地区：[1]哈尔滨医科大学附属第一临床医学院内科危重症病房,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一临床医学院麻醉科,黑龙江哈尔滨150001 [3]哈尔滨医科大学附属第一临床医学院CCU,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2015年第34期6762-6765,共4页Progress in Modern Biomedicine

基　　金：黑龙江省科技厅科学技术研究项目(GC06C41902)

摘　　要：目的:利用常规药物加心区交感神经阻滞(CSNB)技术治疗(以下简称治疗)慢性心力衰竭,观察治疗前后患者血浆N-端脑利钠肽前体(NT-pro BNP)水平变化情况及利用NT-pro BNP评价常规药物加CSNB对心衰治疗的有效性。方法:对54例慢性心衰患者给予常规药物加CSNB治疗,比较治疗前后血浆NT-pro BNP的水平、左室射血分数(LVEF)、左室舒张末内径(LVEDD)变化情况,随访6个月内不良事件(以下简称事件)发生率(包括全因病死率和再入院率之和)。结果:治疗后患者3-8分钟即感觉呼吸困难等临床症状体征明显减轻,住院期间患者尿量明显增多,无一例死亡;治疗14日及出院时血浆NT-pro BNP明显下降(出院时下降比例为61.4%),与治疗前比较其差异有显著统计学意义(P<0.01);LVEF升高,与治疗前比较其差异有显著统计学意义(P<0.01);住院14日及出院时LVEDD较入院时缩小。随访6个月,发生事件12例(22.2%)。结论:NT-pro BNP是评价心衰治疗有效性的可信指标,常规药物加CSNB治疗心衰的临床疗效明显优于单纯常规药物治疗。Objective： To observe of changes plasma N-terminal brain natfiuretic peptide （NT-proBNP）level in patients with chronic heart failure（CHF） undergone cardiacsympathetic blockade（CSNB） treatment with conventional drugs, and evaluate the value of NT-proBNP in predicting CSNB for the treatment of CHF. Methods： A total of 54 cases of CHF patients undergone CSNB with conventional drugs were measured Plasma NT-proBNP level, LVEF and LVEDD, Patients were followed up for 6 months, The primary end point was adverse events incliding all-cause mortality and readmission. Results： The symptoms of dyspnea were reduced at 3-8 minutes after treatment, The urine volume of patients increased significantly, and there was no case of death at hospitalization period, Plasma NT-proBNP decreased significantly （61.4） at 14 days and Discharged （P 〈 0.01）, LVEF increased than 14 days and Discharged （P 〈 0.01） and LVEDD reduced, the event rate following up for 6 months was 22.2. Conclusion： The NT- proBNP level is credible for evaluation of treatment in CHF. The clinical curative effect of CSNB with conventional drugs is better than conventional drugs for the treatment in CHF.

关 键 词：慢性心力衰竭 N-端脑利钠肽前体 心区交感神经阻滞 

分 类 号：R541.61[医药卫生—心血管疾病]