磷酸肌酸钠联合前列地尔对急性发作期CHF的疗效及血清NT-proBNP的影响  

Therapeutic effect of creatine phosphate sodium combined alprostadil injection on acute-exacerbation CHF and its influence on serum NT-proBNP level

作　　者：高永超[1] 

机构地区：[1]贵州省绥阳县人民医院内二科,贵州遵义563300

出　　处：《心血管康复医学杂志》2018年第1期73-76,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨注射用磷酸肌酸钠(CP)联合前列地尔注射液对急性发作期慢性充血性心衰患者(CHF)患者的疗效及血清N末端B型利钠肽前体(NT-proBNP)水平的影响。方法:选择我院收治的120例CHF急性发作期患者作为研究对象。根据随机数字表法,患者被随机均分为CP组(在常规治疗基础上接受注射用CP)和联合治疗组(在CP组基础上加用前列地尔注射液),疗程均为2周。测量比较两组治疗前后心输出量(CO)、每博输出量(SV)、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、血清NT-proBNP水平,以及治疗总有效率和不良反应发生率。结果:与治疗前比较,两组治疗2周后CO、SV和LVEF显著升高,LVEDd显著降低(P均=0.001,CP组CO除外);与CP组比较,治疗2周后联合治疗组CO[(4.9±1.5)L比(5.6±1.6)L]、SV[(70.6±7.5)ml比(79.2±7.6)ml]和LVEF[(42.9±7.6)%比(49.3±8.6)%]升高更显著,LVEDd[(58.4±5.3)mm比(43.6±5.5)mm]降低更显著(P<0.05或<0.01)。与治疗前比较,治疗1周、2周后两组的血清NT-proBNP水平均显著降低,且2周后的显著低于1周后,P均=0.001。与CP组比较,治疗1周、2周后联合治疗组的血清NT-proBNP水平[1周后:(708.6±137.6)ng/L比(611.4±121.4)ng/L,2周后:(573.9±132.9)ng/L比(359.1±114.2)ng/L]降低更显著,P均=0.001。联合治疗组的总有效率显著高于CP组(95.0%比81.7%),P=0.023。两组不良反应发生率无显著差异(P=0.675)。结论:磷酸肌酸钠联合前列地尔治疗急性发作期充血性心力衰竭患者,可显著改善患者的心功能,提高治疗有效率,值得临床推广。Objective： To explore therapeutic effect of creatine phosphate sodium （CP） injection combined alprostadil injection on acute-exacerbation chronic congestive heart failure （CHF） and its influence on serum level of N terminal pro B-type natriuretic peptide （NT-proBNP）. Methods： A total of 120 acute-exacerbation CHF patients treated in our hospital were selected. According to random number table, they were randomly and equally divided into CP group （received CP injection based on routine treatment） and combined treatment group （received alprostadil injection based on CP group）, and both groups were treated for two weeks. Cardiac output （CO）, stroke volume （SV）, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic dimension （LVEDd） and serum NT-proBNP level before and after treatment, total effective rate and incidence rate of adverse reactions were measured and compared between two groups. Results： Compared with before treatment, after two-week treatment, there were significant rise in CO, SV and LVEF, and significant reduction in LVEDd in two groups except CO of CP group （P = 0. 001 all） ; compared with CP group, after two-week treatment, there were significant rise in CO [ （4.9 ± 1.5） L vs. （5. 6 ± 1.6） L], SV [ （70.6 ± 7. 5） ml vs. （79.2 ± 7. 6） ml] and LVEF [ （42. 9 ± 7. 6） % vs. （49.3 ± 8. 6） %], and significant reduction in LVEDd [ （58. 4 ± 5. 3） mm vs. （43. 6 ± 5. 5） mini in combined treatment group, P〈0.05 or 〈0.01. Compared with before treatment, there was significant reduction in serum NT-proBNP level in two groups on one and two weeks after treatment, and those of after two weeks were significantly lower than those of after one week, P = 0. 001 all. Compared with CP group, after one-week and two-week treatment, there was significant reduction in serum NT-proBNP level [after one week.. （708. 6 ± 137. 6） ng/L vs. （611.4 ± 121.4） ng/L, after two weeks： （573.9 ± 132. 9） ng/L vs. （3

关 键 词：心力衰竭 磷酸肌酸 前列地尔 

分 类 号：R541.61[医药卫生—心血管疾病]