重组人脑利钠肽联合沙库巴曲缬沙坦钠片治疗冠状动脉粥样硬化性心脏病心力衰竭疗效观察  

Effect of recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium tablet in the treatment of patients with heart failure caused by coronary atherosclerotic heart disease

作　　者：陶涛 刘毅龙 TAO Tao;LIU Yilong(Department of Vasculocardiology,Xi′an Hospital of Traditional Chinese Medicine,Xi′an 710016,Shaanxi Province,China)

机构地区：[1]西安市中医医院心血管内科,陕西西安710016

出　　处：《新乡医学院学报》2022年第3期258-263,共6页Journal of Xinxiang Medical University

摘　　要：目的探讨重组人脑利钠肽(rhBNP)联合沙库巴曲缬沙坦钠片治疗冠状动脉粥样硬化性心脏病心力衰竭的临床效果。方法选择2016年1月至2019年12月西安市中医医院收治的123例冠状动脉粥样硬化性心脏病心力衰竭患者为研究对象,根据治疗方法将患者分为A组、B组和C组,每组41例。所有患者给予吸氧、利尿、纠正水电解质紊乱及酸碱失衡、强心、抗血小板聚集等常规治疗措施,在常规治疗基础上,A组患者给予沙库巴曲缬沙坦钠片治疗,B组患者给予rhBNP治疗,C组患者给予沙库巴曲缬沙坦钠片和rhBNP联合治疗,3组患者均治疗4周。治疗后评估3组患者的临床疗效,并观察治疗期间患者不良反应发生情况。治疗前和治疗后,应用彩色多普勒超声诊断仪检测患者左心室射血分数(LVEF)、心输出量(CO)、每博输出量(SV)和心脏指数(CI),采用酶联免疫吸附试验测定血清心锚重复蛋白(CARP)、醛固酮(ALD)、细胞间黏附分子-1(ICAM-1)水平,采用放射免疫法测定血清线粒体偶联因子6(CF6)水平,采用明尼苏达生活质量量表(MLHFQ)评估患者的生活质量,并测量患者6 min步行距离(6MWD)。结果A组、B组和C组患者治疗总有效率分别为75.61%(31/41)、78.05%(32/41)、95.12%(39/41),C组患者治疗总有效率显著高于A组和B组(χ^(2)=6.248、5.145,P<0.05),A组与B组患者治疗总有效率比较差异无统计学意义(χ^(2)=0.069,P>0.05)。治疗前3组患者的LVEF、SV、CO、CI比较差异无统计学意义(P>0.05),3组患者治疗后的LVEF、SV、CO、CI显著高于治疗前(P<0.05);治疗后,C组患者的LVEF、SV、CO、CI显著高于A组和B组(P<0.05),A组与B组患者的LVEF、SV、CO、CI比较差异无统计学意义(P>0.05)。治疗前3组患者血清CF6、CARP、ALD和ICAM-1水平比较差异无统计学意义(P>0.05),3组患者治疗后血清CF6、CARP、ALD和ICAM-1水平显著低于治疗前(P<0.05);治疗后,C组患者血清CF6、CARP、ALD和ICAM-1水平�Objective To investigate the clinical effect of recombinant human brain natriuretie peptide(rhBNP)combined with sacubitril valsartan sodium tablet in the treatment of patients with heart failure caused by coronary atherosclerotic heart disease.Methods A total of 123 patients with coronary atherosclerotic heart disease and heart failure treated in Xi′an Hospital of Traditional Chinese Medicine from January 2016 to December 2019 were selected as the research subjects,and the patients were divided into group A,group B and group C according to the treatment methods,with 41 cases in each group.All patients were treated with routine treatment measures such as oxygen inhalation,diuresis,correcting fluid-electrolyte disorder and acid-base imbalance,cardiotonic and antiplatelet aggregation.On the basis of routine treatment,the patients in the group A were treated with sacubitril valsartan sodium tablets,and the patients in the group B were treated with rhBNP;and the patients in the group C were treated with sacubitril valsartan sodium tablets and rhBNP;the patients in the three groups were treated for four weeks.The clinical effect of the patients in the three groups was evaluated after treatment,and the adverse reactions during treatment were observed.Before and after treatment,the left ventricular ejection fraction(LVEF),cardiac output(CO),stroke volume(SV)and cardiac index(CI)were measured by color Doppler ultrasound diagnostic instrument.The levels of serum cardiac ankyrin repeat protein(CARP),aldosterone(ALD)and intercellular adhesion molecule-1(ICAM-1)were detected by enzyme-linked immunosorbent assay.The level of serum mitochondrial coupling factor 6(CF6)was detected by radioimmunoassay,and the quality of life was assessed by Minnesota living with heart failure questionnaire(MLHFQ),and the 6-minute walking distance(6MWD)of patients was measured.Results The total effective rates of patients in the group A,group B and group C were 75.61%(31/41),78.05%(32/41)and 95.12%(39/41),respectively.The total effective rate of

关 键 词：冠状动脉粥样硬化性心脏病 心力衰竭 重组人脑利钠肽 沙库巴曲缬沙坦钠片 心锚重复蛋白 偶联因子6 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]