降钙素原指导下早期使用抗生素联合重组人脑利钠肽治疗心力衰竭临床疗效观察  

Clinical Observation of Early Use of Antibiotics Combined with Recombinant Human Brain Natriuretic Peptide under the Guidance of Calcitonin to Treat Heart Failure

作　　者：于胜泳[1,2] 吕先念 YU Sheng-yong;LV Xian-nian(Department of cardiovascular medicine,the Fifth People's Hospital of Datong,Datong Shanxi,037009;the First Affiliated Hospital of Shanxi Datong University,Datong Shanxi,037009;ICU,the Fifth People's Hospital Datong,Datong Shanxi,037009)

机构地区：[1]大同市第五人民医院心血管内科,山西大同037009 [2]山西大同大学第一附属医院,山西大同037009 [3]大同市第五人民医院重症医学科,山西大同037000

出　　处：《山西大同大学学报（自然科学版）》2018年第6期51-53,64,共4页Journal of Shanxi Datong University(Natural Science Edition)

摘　　要：目的观察降钙素原(PCT)指导下,早期抗生素联合重组人脑利钠肽治疗心力衰竭的临床疗效。方法将心力衰竭患者(心功能Ⅲ级与Ⅳ级)180例随机双盲分为对照组和治疗组各90例。所有患者降钙素原水平在0.05～0.2 ng/mL范围内,已大于正常高限值。对照组:重组人脑利钠肽+常规抗心衰治疗;治疗组:早期抗生素+重组人脑利钠肽+常规抗心衰治疗。检测所有入组患者入院时、治疗48 h、治疗96 h,血清降钙素原(PCT)含量、血清C反应蛋白(CRP)含量、左心室脏射血分数、脑钠肽前体NTpro-BNP1、氧和指数、血清光抑素-C。结果 (1)治疗96 h,与对照组比较,治疗组左心室射血分数显著升高(P <0.05);脑钠肽前体NTproBNP1显著降低(P <0.05);降钙素原水平显著降低(P> 0.05);C反应蛋白(CRP)与对照组比较(P <0.05)。(2)治疗96 h,与对照组比较,治疗组氧和指数显著升高(P <0.05);血清光抑素-C水平显著降低(P <0.05)。结论降钙素原(PCT)指导下,早期抗生素联合重组人脑钠肽治疗心力衰竭,临床疗效优于常规抗心衰治疗方案,患者可能更早获益。Objective To observe the clinical efficacy of early antibiotics combined with recombinant human brain natriuretic peptide in the treatment of heart failure under the guidance of procalcitonin(PCT).Methods 180 patients with heart failure(grade Ⅲ and Ⅳ)were divided into control group and treatment group,with 90 cases in each group.The procalcitonin level in all patients was within the range of 0.05~0.2 ng/ml,which was higher than the normal high limit.the patients in control group are treated with recombinant human brain natriuretic peptide combined with routine anti-heart failure,while those in treatment group are treated with early antibiotics and recombinant human brain natriuretic peptide combined with routine anti-heart failure.The serum procalcitonin(PCT)content,serum c-reactive protein(CRP)content,left ventricular ejection fraction,brain natriuretic peptide precursor NTpro-BNP1,oxygen index,and serum photostatin-C were measured on admission,48 hours after treatment and 96 hours after treatment respectively.Results 1.The ejection fraction of left ventricular in the treatment group significantly increased after 96 hours of treatment compared with the control group(P<0.05).Brain natriuretic peptide precursor ntpro-bnp1 was significantly reduced,and the difference was statistically significant(P<0.05).Procalcitonin levels were significantly reduced,and the difference was statistically significant(P<0.05).There was no significant difference between CRP and control group(P>0.05).2.After 96 hours of treatment,oxygen index in the treatment group were significantly increased and the difference was statistically significant compared with the control group(P<0.05).Serum levels of phostatin-C were significantly decreased,and the difference was statistically significant(P<0.05).Conclusion Under the guidance of calcitonin(PCT),the early antibiotics combined with recombinant human brain natriuretic peptide in the treatment of heart failure has better clinical efficacy than conventional anti-heart failure treatment,and

关 键 词：降钙素原 早期使用抗生素 重组人脑利钠肽 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]