环磷腺苷葡胺注射液联合培哚普利对慢性心衰的临床疗效  

Clinical Effect of Meglumin Cyclic Adenosine Monophosphate Combined with Perindopril on Chronic Heart Failure

作　　者：冯晓生 林冬丽 FENG Xiao-sheng;LIN Dong-li(Department of Emergency,Dafeng Hospital,Chaoyang District,Shantou,Guangdong Province,515154 China;Department of Anesthesiology,Dafeng Hospital,Chaoyang District,Shantou,Guangdong Province,515154 China)

机构地区：[1]广东省汕头市潮阳区大峰医院急诊科,广东汕头515154 [2]广东省汕头市潮阳区大峰医院麻醉科,广东汕头515154

出　　处：《中外医疗》2020年第29期23-26,共4页China & Foreign Medical Treatment

摘　　要：目的评价环磷腺苷葡胺(MAC)联合培哚普利对慢性心力衰竭(CHF)的临床疗效。方法2016年8月—2019年11月方便选择该院276例CHF患者,按照随机对照原则,根据患者住院前后将其分为3组,分别为常规组、培哚普利组、联合组。常规组予以常规抗心衰、培哚普利组在此基础上加用培哚普利组,联合组则加用环磷腺苷葡胺注射液联合培哚普利治疗,记录并比较患者的LVEF和左室舒张半径(LVEDD)、NT-proBNP浓度。结果①外周血中NT-proBNP浓度随着NYHA分级增加逐渐上升,差异有统计学意义(P<0.01);②培哚普利组和联合组的治疗有效率(91.3%)、(93.5%)明显高于常规组(75.0%),差异有统计学意义(χ^2=8.730、11.830,P<0.01);联合组的治疗有效率(93.5%)高于培哚普利组(91.3%),差异无统计学意义(χ^2=0.310,P>0.05);③经2周治疗后,培哚普利组NT-proBNP(1197.0±371.4)pg/mL、LVEDD(63.0±7.7)mm和联合组的NT-proBNP(877.6±311.4)pg/mL与LVEDD(53.9±7.0)mm均明显低于常规组(1592.3±379.8)pg/mL、(59.8±6.9)mm,培哚普利组LVEF(47.5±7.0)%、联合组的LVEF(48.0±5.8)%明显升高于常规组(43.1±7.1)%,差异有统计学意义(t=7.138、5.454、8.729、5.973、4.232、4.657,P<0.01);联合组的外周血NT-proBNP水平(877.6±311.4)pg/mL明显低于培哚普利组(1197.0±371.4)pg/mL,差异有统计学意义(t=6.321,P<0.01);LVEDD及LVEF水平较培哚普利组差异无统计学意义(t=0.528、0.295,P>0.05)。④外周血NT-proBNP浓度与LVEDD及NYHA呈正相关,与LVEF呈负相关(P<0.05)。结论在常规抗心衰的前提下,应用MAC联合培哚普利治疗CHF可进一步降低血浆NT-proBNP水平,有助于改善患者生活质量,是一种安全、有效的治疗方式。Objective To evaluate the clinical efficacy of meglumine cyclic adenosine monophosphate(MAC)combined with perindopril on chronic heart failure(CHF).Methods From August 2016 to Norember 276 CHF patients in the undergraduate department of the hospital were selected.According to the principle of randomized control,they were divided into 3 groups based on before and after hospitalization:routine group,perindopril group,and combined group.The routine group was given routine anti-heart failure and training.On this basis,the indopril group received the perindopril group,and the combined group was treated with meglumin cyclic adenosine monophosphate combined with perindopril.The patients’LVEF and left ventricular diastolic radius(LVEDD)and NT-proBNP concentration were recorded and compared.Results 1.The concentration of NT-proBNP in the peripheral blood gradually increased with the increase of NYHA grade,and there was a statistical difference between the pairwise comparisons(P<0.01);2.The effective rate of the perindopril group and the combination group(91.3%),(93.5%)were significantly higher than the conventional group(75.0%),with statistical differences(χ^2=8.730,11.830,P<0.01);the treatment efficiency of the combination group(93.5%)was higher than that of the perindopril group(91.3%),no statistically significant difference(χ^2=0.310,P>0.05);3.After 2 weeks of treatment,NT-proBNP(1197.0±371.4)pg/mL,LVEDD(63.0±7.7)mm and the combination group of NT-proBNP(877.6±311.4)pg/mL and LVEDD(53.9±7.0)mm were significantly lower than the conventional group(1592.3±379.8)pg/mL,(59.8±6.9)mm,perindopril group LVEF(47.5±7.0)%,combined group LVEF(48.0±5.8)%was significantly higher than that in the routine group(43.1±7.1)%,the difference was statistically significant(t=7.138,5.454,8.729,5.973,4.232,4.657,P<0.01);the peripheral blood NT-proBNP level of the combination group(877.6±311.4)pg/mL was significantly lower than the perindopril group(1197.0±371.4)pg/mL,with statistical difference(t=6.321,P<0.01);LVEDD and LVEF leve

关 键 词：慢性心衰 环磷腺苷葡胺 培哚普利 

分 类 号：R541.6[医药卫生—心血管疾病]