前列地尔对高原型心脏病合并心功能不全患者血气指标、NT-proBNP及心功能的影响  

Effects of alprostadil on blood gas indexes,NT-proBNP and cardiac function in patients with plateau heart disease complicated with cardiac insufficiency

作　　者：刁元彬 钱稚萍 罗江秀 徐立彦 谭裕尧 DIAO Yuanbin,QIAN Zhiping,LUO Jiangxiu,XU Liyan,TAN Yuyao(Department of Cardiology, Ganzi People＇s Hospital of Sichuan Province, Kangding 626000,China)

机构地区：[1]四川省甘孜州人民医院心血管内科,康定626000

出　　处：《疑难病杂志》2018年第7期658-662,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察前列地尔对高原型心脏病合并心功能不全患者血气指标、NT-proBNP及心功能的影响。方法选择2013年10月—2016年10月四川省甘孜州人民医院心血管内科治疗高原型心脏病合并心功能不全患者70例作为研究对象。随机数字表法均分为观察组和对照组各35例。2组患者均给予吸氧、平喘、强心、利尿、维持电解质平衡等常规治疗,观察组在常规治疗的基础上加用前列地尔治疗,比较2组患者治疗前后动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、动脉血氧饱和度(SaO_2)、肺动脉收缩压(SPAP)、左右室射血分数、N末端脑钠肽前体(NT-proBNP)的变化情况及不良反应。结果与治疗前相比,观察组患者治疗14 d后PaO_2、PaCO_2、SaO_2和SPAP均有明显改善(t/P=10.193/0.000、2.592/0.012、23.227/0.000、8.620/0.000),且观察组PaO_2和SaO_2水平高于对照组(t/P=6.022/0.000、9.900/0.000),PaCO_2、SPAP低于对照组(t/P=2.018/0.044、4.792/0.000);观察组右室射血分数、左室射血分数均较治疗前升高(t/P=9.229/0.000、8.501/0.000),且观察组高于对照组(t/P=6.454/0.000、5.285/0.000);治疗14 d后,2组血浆NT-proBNP均下降,且观察组低于对照组(t=14.817,P=0.000);观察组不良反应发生率为11.43%,低于对照组的14.29%(χ~2=0.128,P=0.721)。结论前列地尔能够有效改善高原性心脏病合并心功能不全患者的气血指标,降低血浆NT-proBNP浓度,改善心功能,是一种安全、高效的治疗方法,值得临床推广应用。Objective To investigate the effect of alprostadil on blood gas index,NT-proBNP and cardiac function in patients with plateau heart disease complicated with cardiac insufficiency. Methods From October 2013 to October 2016, 70 patients with high prototypic heart disease and heart failure treated in department of cardiology in Ganzi People＇s Hospital of Sichuan Province were selected as study subjects. Patients were randomly divided into observation group and control group with each group of 35 cases. Patients in both groups were given conventional therapy such as oxygen inhalation, anti-asthma and maintaining electrolyte balance. The observation group was treated with alprostadil on the basis of conventional treatment. The Pa02,arterial carbon dioxide（ PaCO2）,arterial oxygen saturation（SaO2）,pulmonary arterial pressure（SPAP）,left ventricular ejection fraction,left ventricular systolic function,N terminal pro brain natriuretic peptide, adverse reaction were recorded.Results Compared with pre-treatment, Pa02,PaC02,SaO2,and SPAP were significantly improved in the observation group after 14 days of treatment（t/P = 10. 193/0. 000.t/P =2. 596/0. 012.t/P =23.227/0. 00,t/P= 8. 620/0. 000）,and the PaO2 and SaO2 levels in the observation group were higher than those in the control group（t/P =6. 022/0. 000, t/P = 9. 900/0.000）,PaCO2 and SPAP were lower than the control group（t/P =2.018/0.044,t/P =4. 792/0.000）; The right ventricular ejection fraction, left ventricular ejection fraction were all higher than those before treatment（t/P =9. 229/0. 000.t/P =8.501/0.000） and were higher than those of the control group（t/P =6.454/0.000.t/P =5. 285/0. 000）; plasma NT-proBNP were decreased in both groups after 14 days＇ treatment,and the observation group was lower than the control group（t =14. 817,P =0.000）; the observation group＇s incidence of adverse reaction was 11.43%, which was lower than that of the control group（ 14.29%）（χ^2=0.128,P = 0. 721）. Conclusion Alprostadil can effect

关 键 词：高原型心脏病 心功能 前列地尔 血气分析 N-末端脑钠肽前体 

分 类 号：R541.6[医药卫生—心血管疾病] R541.9[医药卫生—内科学]