重组人脑利钠肽联合多巴胺治疗急性心力衰竭并低血压患者的临床效果观察  

Clinical effect of recombinant human brain natriuretic peptide combined with dopamine in patients with acute heart failure combined with hypotension

作　　者：曾爱辉[1] 马建林[1] 张敬文[1] 王卫[1] Zeng Aihui;Ma Jianlin;Zhang Jingwen;Wang Wei(Department of cardiology, Hainan Provincial People 's Hospital, Haikou 517700, China)

机构地区：[1]海南省海口市海南省人民医院心内科,海口517700

出　　处：《中国循证心血管医学杂志》2017年第8期951-953,956,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨急性心力衰竭(AHF)合并低血压患者采用重组人脑利钠肽联合多巴胺治疗的临床效果。方法选取2015年3月~2016年5月于海南省人民医院接受治疗的AHF合并低血压患者52例,采用随机数表法分为两组,对照组27例采用多巴胺治疗,观察组25例采用重组人脑利钠肽联合多巴胺治疗,观察比较两组患者治疗后心率、平均动脉压、收缩压、舒张压、生物标志物N末端脑钠肽原(NTproBNP)以及心功能改善情况。结果治疗后,两组患者的心率都有所降低,观察组(86.45±12.56)min低于对照组(93.45±8.98)min;两组患者的收缩压、舒张压及平均动脉压都有所升高,观察组收缩压(108.45±12.36)、舒张压(68.98±8.97)mm Hg、平均动脉压(76.12±9.45)mm Hg分别高于对照组收缩压(93.56±10.39)mm Hg、舒张压(60.12±8.16)mm Hg及平均动脉压(69.78±8.89)mm Hg,两组比较差异显著(P<0.05);两组患者的NT-por BNP均降低,观察组低于对照组,左心室射血分数(LVEF)均升高,观察组高于对照组,两组比较差异显著(P<0.05);两组患者治疗后左心室舒张末内径(LVEDD)均有所减小,但两组间差异无统计学意义(P>0.05);观察组患者治疗后的总有效率为96.00%高于对照组66.67%,两组比较差异显著(P<0.05)。结论重组人脑利钠肽联合多巴胺治疗AHF合并低血压患者,能够有效改善患者的心功能。Objective To study the clinical effect of recombinant human brain natriuretic peptide combined with dopamine in patients with acute heart failure(AHF)combined with hypotension.Methods52patients with AHF with hypotension from March2015to May2016were randomly divided into two groups:control group(27patients treated with dopamine),and observation group(25patients treated with dopamine and recombinant human brain natriuretic peptide).The changes of heart rate,mean arterial pressure,diastolic blood pressure,diastolic blood pressure,N-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac function were compared.Results After treatment,the heart rate of the two groups was decreased,and the observation group(86.45±12.56min)was lower than the control group(93.45±8.98min).Two groups of patients with systolic blood pressure,diastolic blood pressure and mean arterial pressure have increased.The mean systolic blood pressure(108.45±12.36mmHg),diastolic blood pressure(68.98±8.97mmHg)and mean arterial pressure(76.12±9.45mmHg)were significantly higher than those in the control group(93.56±10.39mmHg),diastolic blood pressure(60.12±8.16mmHg)and mean arterial pressure(69.78±8.89mmHg)(P<0.05).NT-porBNP was decreased in both groups and NT-porBNP in the observation group was lower than that in the control group.Left ventricular ejection fraction(LVEF)increased in both groups and the control group(P<0.05).Left ventricular end diastolic diameter(LVEDD)was decreased in both groups after treatment,but there was no significant difference between the two groups(P>0.05).The total effective rate in the observation group was96.00%higher than that in the control group(66.67%),and the difference was significant(P<0.05).Conclusion Recombinant human brain natriuretic peptide combined with dopamine in treatment of AHF with hypotension can effectively improve the cardiac function of patients.

关 键 词：脑利钠肽 多巴胺 急性心力衰竭 低血压 

分 类 号：R541.61[医药卫生—心血管疾病]