重组人脑利钠肽对急性冠脉综合征伴心力衰竭患者的影响  

Effect of Recombinant Human Brain Natriuretic Peptide on patients with acute coronary syndrome and heart failure

作　　者：方文宾[1] 王文标[1] 潘一先 邹立波[1] 梁亚非[1] 董扬[1] 刘俊[1] 俞北伟 FANG Wenbin;WANG Wenbiao;PAN Yixian;ZOU Libo;LIANG Yafei;DONG Yang;LIU Jun;YU Beiwei(Department of Cardiology,People's Hospital of Jinhua City in Zhejiang Province,Jinhua321000,China)

机构地区：[1]浙江省金华市人民医院心内科,浙江金华321000

出　　处：《中国现代医生》2020年第25期42-45,共4页China Modern Doctor

基　　金：浙江省公益技术应用研究资助项目(LGD19H020001);浙江省医学会临床科研基金项目(2016ZYC-A99)。

摘　　要：目的分析重组人脑利钠肽(rhBNP)对急性冠脉综合征(ACS)伴心力衰竭患者的影响。方法选取2017年1月~2018年12月在本院接受治疗的ACS合并心力衰竭患者232例,随机数字表法分成对照组58例使用常规疗法和硝酸甘油治疗,治疗组174例使用常规疗法和rhBNP治疗;观察患者治疗前后神经内分泌激素和氨基末端脑钠尿肽(NT-proBNP)含量、心功能指标、6 min步行距离及治疗后发生心脏不良事件情况。结果治疗后6 h治疗组患者血清醛固酮、肾上腺素、血管紧张素Ⅱ、肾素、去甲肾上腺素及NT-proBNP含量较治疗前、对照组降低(P<0.05);治疗后1个月治疗组患者LVEF较治疗前、对照组升高,LVESV、LVEDV较治疗前、对照组降低(P<0.05);治疗后1个月治疗组患者6 min步行距离较治疗前、对照组升高,治疗后6个月治疗组心脏不良事件发生率低于对照组(P<0.05)。结论rhBNP可显著改善ACS合并心力衰竭患者心功能指标,降低血清神经内分泌激素、NTproBNP含量和心脏不良事件发生率。Objective To analyze the effect of Recombinant Human Brain Natriuretic peptide(rhBNP)on patients with acute coronary syndrome(ACS)and heart failure.Methods 232 patients with ACS complicated with heart failure who were treated in our hospital from January 2017 to December 2018 were randomly divided into the control group(58 patients)who received conventional therapy and nitroglycerin,and the observation group(174 patients).The patients were treated with conventional therapy and rhBNP;the levels of neuroendocrine hormone and amino terminal brain natriuretic peptide(NT-proBNP),cardiac function index,walking distance of 6 min and cardiac adverse events after treatment were observed before and after treatment.Results The levels of serum aldosterone,adrenaline,angiotensinⅡ,renin,nore pinephrine and NT-proBNP were significantly lower in the observation group than in the control group(P<0.05).The LVEF of patients was higher than that before treatment and control group.The LVESV and LVEDV were lower than those before treatment and control group(P<0.05).The 6-minute walking distance of the observation group was higher than that before treatment and control group,and 6 after treatment.The incidence of adverse cardiac events in the monthly observation group was lower than that in the control group(P<0.05).Conclusion rhBNP can significantly improve cardiac function in patients with ACS complicated with heart failure,and reduce serum neuroendocrine hormone,NT-proBNP content and incidence of adverse cardiac events.

关 键 词：急性冠脉综合征 心力衰竭 重组人脑利钠肽 超声心动图 氨基末端脑钠尿肽 

分 类 号：R541.6[医药卫生—心血管疾病]