重组人脑利钠肽联合左西孟旦治疗老年急性前壁心梗伴失代偿性心衰疗效及对血清NT-proBNP Copeptin水平的影响  

Therapeutic Effect of Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan on Senile Acute Anterior Myocardial Infarction with Decompensated Heart Failure in the Elderly and Its Influence on Serum NT-proBNP and Copeptin Levels

作　　者：刘玉彬 廖春梅 庄燕妮 谢周妮 李陈 肖灵芝 LIU Yubin;LIAO Chunmei;ZHUANG Yanni(Guilin People's Hospital,Guangxi Guilin 541002,China)

机构地区：[1]广西壮族自治区桂林市人民医院,广西桂林541002

出　　处：《河北医学》2022年第3期498-503,共6页Hebei Medicine

基　　金：广西壮族自治区卫生健康委员会项目,(编号:Z20190400)。

摘　　要：目的:分析重组人脑利钠肽(rhBNP)联合左西孟旦治疗老年急性前壁心梗伴失代偿性心衰的疗效及对血清N末端B型脑钠肽(NT-proBNP)、肽素(Copeptin)水平的影响。方法:选取我院2017年9月至2021年3月收治的151例老年急性前壁心梗伴失代偿性心衰患者,使用简单随机法分为联合组(n=76)、对照组(n=75),联合组与对照组均在常规抗缺血、抗心衰治疗的基础上接受左西孟旦治疗,联合组加用rhBNP治疗。对比联合组与对照组患者治疗效果、不良反应以及血清NT-proBNP、Copeptin变化,分析联合治疗方案的临床价值。结果:与治疗前相比,治疗3d后联合组与对照组患者左心室射血分数(LVEF)、心排血量(CO)、心指数(CI)、外周阻力指数(SVRI)均上升,联合组升高幅度均大于对照组,存在统计学差异(P<0.05)。治疗3d后联合组总有效率为88.16%,大于对照组的65.33%,存在统计学差异(P<0.05)。联合组、对照组治疗期间不良反应发生率分别为5.26%、5.33%,组间比较未见统计学差异(P>0.05)。治疗3d后联合组与对照组患者血清NT-proBNP、Copeptin均较治疗前下降,联合组治疗3d后下降幅度均大于对照组,存在统计学差异(P<0.05)。结论:在标准化治疗及左西孟旦的基础上,给予rhBNP能够进一步改善老年急性前壁心梗伴失代偿性心衰患者心功能,降低NT-proBNP、Copeptin水平,并提高临床疗效,且具备良好的安全性。Objective:To analyze the therapeutic effect of recombinant human brain natriuretic peptide(rhBNP)combined with levosimendan in the treatment of senile acute anterior myocardial infarction with decompensated heart failure in the elderly and its influence on serum levels of NT-proBNP and Copeptin.Methods:Totally 151 elderly patients with acute anterior myocardial infarction and decompensated heart failure admitted in our hospital from September 2017 to March 2021 were randomly divided into the combination group(n=76)and the control group(n=75).Both groups were treated with levosimendan on the basis of routine anti-ischemia and anti-heart failure treatment,and the combined group was treated with rhBNP additionally.The treatment effect,adverse reactions,changes of serum NT-proBNP and Copeptin were compared between the combination group and the control group,and the clinical value of the combined treatment regimen was analyzed.Results:The left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac index(CI)and peripheral vascular resistance index(SVRI)of both groups were higher after 3 days of treatment then before treatment,and the increase range of combination group was higher than that of control group with statistically significant difference(P<0.05).Three days after treatment,the total effective rate of the combination group was 88.16%,which was higher than the control group at 65.33%with statistically significant difference(P<0.05).The incidence rate of adverse reactions in combination group and control group during treatment was 5.26%and 5.33%,respectively,and there was no significant difference between groups(P>0.05).The levels of serum NT-proBNP and Copeptin in both groups decreased after 3 days of treatment,and the decrease range of combination group was higher than that of control group with statistically significant difference(P<0.05).Conclusion:On the basis of standardized treatment and levosimendan,rhBNP can further improve the cardiac function of elderly patients with acute anterior myocardial i

关 键 词：重组人脑利钠肽 左西孟旦 心梗 心衰 

分 类 号：R541.6[医药卫生—心血管疾病] R542.22[医药卫生—内科学]