重组人脑利钠肽治疗急性心梗后失代偿性心力衰竭的效果评价  

Evaluation of effect by recombinant human brain natriuretic peptide in the treatment of decompensated heart failure after acute myocardial infarction

作　　者：陈曦[1] 朱媛[1] 刘俭雄[1] 石理[1] 

机构地区：[1]珠海市人民医院心血管内科,519000

出　　处：《中国实用医药》2017年第10期105-107,共3页China Practical Medicine

摘　　要：目的分析重组人脑利钠肽治疗急性心肌梗死(心梗)后失代偿性心力衰竭的临床疗效。方法 96例急性前壁心梗后失代偿性心力衰竭患者为研究对象,随机分为对照组和实验组,每组48例。两组均给予抗缺血及利尿常规治疗,对照组在常规治疗基础上联合使用多巴酚丁胺治疗,实验组在常规治疗基础上联合使用重组人脑利钠肽治疗,比较两组患者治疗前及治疗后72 h血脑钠肽(BNP)、左室射血分数(LVEF)、心功能Killip分级,并比较两组患者治疗后30 d内的病死率。结果治疗前两组患者BNP水平、LVEF比较差异无统计学意义(P>0.05);治疗后72 h,两组患者BNP水平明显降低、LVEF明显升高(P<0.05);且实验组患者BNP水平明显低于对照组,LVEF明显高于对照组(P<0.05)。治疗前两组患者心功能Killip分级均为Ⅲ级;而治疗后实验组中Ⅰ级患者比例(62.50%)明显高于对照组(41.67%),Ⅲ级患者比例(10.42%)明显低于对照组(27.08%),心功能Killip分级优于对照组(P<0.05)。两组患者治疗后30d病死率比较差异无统计学意义(P>0.05)。结论相比多巴酚丁胺,重组人脑利钠肽改善急性心梗后失代偿性心力衰竭患者心功能的疗效更显著,且预后效果无差异,值得推广应用。Objective To analyze clinical effect by recombinant human brain natriuretic peptide in the treatment of decompensated heart failure after acute myocardial infarction. Methods A total of 96 patients with decompensated heart failure after acute myocardial infarction as study subjects were randomly divided into control group and experimental group, with 48 cases in each group. Both groups received conventional therapy for anti-ischemia and diuresis. The control group received additional dobutamine to conventional therapy, and the experimental group received additional recombinant human brain natriuretic peptide to conventional therapy. Comparison was made on blood brain natriuretic peptide（BNP）, left ventricular ejection fraction（LVEF）, Killip cardiac functional classification before and after 72 h of treatment between the two groups, along with mortality between the two groups in 30 d after treatment. Results Before treatment, there was no statistically significant difference of BNP level and LVEF between the two groups（P〉0.05）. After 72 h of treatment, both groups had obviously lower BNP level and higher LVEF（P〈0.05）, and the experimental group had much lower BNP level and higher LVEF than the control group（P〈0.05）. Both groups had grade Ⅲ in Killip cardiac functional classification before treatment. After treatment, experimental group had higher proportion of grade Ⅰ cases（62.50%） than the control group（27.08%） and lower proportion of grade Ⅲ cases（10.42%） than the control group（27.08%）. The experimental group had better Killip cardiac functional classification than the control group（P〈0.05）. The difference of mortality between the two groups in 30 d after treatment had no statistical significance（P〉0.05）. Conclusion Comparing with dobutamine, recombinant human brain natriuretic peptide shows more remarkable curative effect in improving cardiac function for patients with decompensated heart failure after acute myocardial infarction, along with similar pr

关 键 词：重组人脑利钠肽 急性心肌梗死 失代偿性心力衰竭 临床疗效 

分 类 号：R541.6[医药卫生—心血管疾病]