重组人脑利钠肽治疗高龄心力衰竭患者的疗效观察及其对血清N端B型钠尿肽原水平的影响  

Effect of recombinant human brain natriuretic peptide on the cardiac function and serum N terminal pro-B-type natriuretic peptide level in elderly patients with heart failure

作　　者：宋添晶 吴玉泉[1] 郦虹 陈晓娜[1] Song Tianjing;Wu Yuquan;Li Hong;Chen Xiaona(Cadre Ward, the 117th Hospital of the Chinese People′s Liberation Army, Hangzhou, Zhejiang 310012, China)

机构地区：[1]解放军第一一七医院干部病房,杭州310012

出　　处：《中国基层医药》2019年第9期1070-1073,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：南京军区医药卫生科研基金课题(14MS147).

摘　　要：目的分析重组人脑利钠肽(rhBNP)对高龄心力衰竭患者疗效、心功能及血清N端B型钠尿肽原(NT-proBNP)水平的影响。方法将解放军第一一七医院2015年1月至2017年12月收治的高龄(年龄≥80岁)心力衰竭患者150例作为研究对象,采用随机数字表法分为两组,对照组给予硝酸甘油治疗,观察组给予rhBNP治疗,两组各75例。比较两组患者血清NT-proBNP水平、左心室射血分数(LVEF)、临床疗效及并发症发生情况。结果两组患者治疗后血清NT-proBNP水平较治疗前均显著降低,且观察组血清NT-proBNP水平[(2 964.42±607.25)pg/mL]较对照组的(4 213.57±524.07)pg/mL显著降低(t=13.49,P<0.01)。两组患者治疗后LVEF的水平较治疗前均显著升高,且观察组LVEF水平[(51.26±4.77)%]较对照组的(46.03±5.22)%显著升高(t=6.41,P<0.01)。观察组治疗总有效率为94.67%(71/75),较对照组的70.67%(53/75)显著升高(χ^2=13.45,P<0.01)。两组患者头痛、血压下降、肾功能恶化及心动过速等并发症发生率差异无统计学意义(P>0.05)。结论rhBNP对高龄心力衰竭患者的治疗可有效改善其呼吸困难及全身症状,有效降低血清NT-proBNP水平,改善心功能,且不会引起严重并发症,具有良好的安全性。Objective To analyze the effect of recombinant human brain natriuretic peptide (rhBNP) on the cardiac function and serum N terminal pro-B-type natriuretic peptide (NT-proBNP) level in elderly patients with heart failure. Methods From January 2015 to December 2017, 150 elderly patients (aged 80 years) with heart failure in the 117th Hospital of the Chinese People′s Liberation Army were selected in the research.According to the digital random list method, the patients were divided into two groups, with 75 cases in each group.The control group was given nitroglycerin treatment, and the observation group was given rhBNP treatment.The levels of serum NT-proBNP, left ventricular ejection fraction (LVEF), clinical efficacy and complications were compared between the two groups. Results After treatment, the levels of serum NT-proBNP in the two groups were significantly lower than before treatment, and the level of NT-proBNP in the observation group [(2 964.42±607.25)pg/mL] was significantly lower than that in the control group [(4 213.57±524.07)pg/mL](t=13.49, P<0.01). After treatment, the levels of LVEF in the two groups were significantly higher than those before treatment, and the level of LVEF in the observation group [(51.26±4.77)%] was significantly higher than that in the control group [(46.03±5.22)%](t=6.41, P<0.01). The total effective rate of the observation group was 94.67%(71/75), which was significantly higher than 70.67%(53/75) of the control group (χ^2=13.45, P<0.01). There was no statistically significant difference in the incidence rate of complications such as headache, blood pressure drop, renal function deterioration and tachycardia etc.in the two groups (P>0.05). Conclusion rhBNP in the treatment of elderly patients with heart failure can effectively improve the symptoms of dyspnea and systemic symptoms, reduce serum NT-proBNP levels, improve heart function, and will not cause serious complications, with good safety, so it is worthy of clinical promotion and application.

关 键 词：心力衰竭 利钠肽 脑 心脏功能试验 老年人 疗效比较研究 

分 类 号：R541.6[医药卫生—心血管疾病]