托伐普坦联合rhBNP治疗左心室射血分数保留型心衰患者的疗效及心脏彩超E/A比值变化分析  

Analysis of efficacy of tolvaptan combined with rhBNP in the treatment of patients with heart failure with preserved left ventricular ejection fraction and the changes of E/A ratio by echocardiography

作　　者：朱庆博 邹科 刘江波[1] ZHU Qingbo;ZOU Ke;LIU Jiangbo(Department of Cardiology,Central Hospital of Nanyang City,Nanyang 473000,Henan,China;Department of Gynecology,Central Hospital of Nanyang City,Nanyang 473000,Henan,China)

机构地区：[1]河南省南阳市中心医院心血管内科,河南南阳473000 [2]河南省南阳市中心医院妇科,河南南阳473000

出　　处：《右江医学》2022年第12期940-945,共6页Chinese Youjiang Medical Journal

摘　　要：目的探讨托伐普坦联合重组人脑钠肽(rhBNP)治疗左心室射血分数保留型心衰(HFpEF)患者的疗效及心脏彩超舒张早期与末期二尖瓣血流峰值速度比值(E/A)变化。方法收集2019年6月—2021年6月收治的134例HFpEF患者,根据随机数字表分成观察组与对照组,各67例,对照组予托伐普坦治疗,观察组在对照组基础上予rhBNP,比较两组临床疗效、不良反应、住院时间、卧床时间,以及两组治疗前后心脏彩超左室舒张末期内径(LVEDd)、E/A比值、舒张末期左室后壁厚度(IVPWTd)及血清N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)水平。结果观察组患者治疗总有效率高于对照组(P<0.05);观察组患者住院时间和卧床时间显著低于对照组(P<0.05);治疗后,两组LVEDd、IVPWTd、NT-proBNP、hs-CRP较治疗前显著减少(P<0.05),E/A比值较治疗前显著增高(P<0.05),且观察组LVEDd、IVPWTd、NT-proBNP、hs-CRP低于对照组(P<0.05),E/A比值高于对照组(P<0.05);观察组不良反应总发生率与对照组比较差异无统计学意义(P>0.05)。结论托伐普坦联合rhBNP治疗左心室射血分数保留型心衰患者的疗效较好,可上调心脏彩超E/A比值,改善患者左心室功能,减轻炎症反应,缩短住院时间,不良反应较少。Objective To investigate the efficacy of tolvaptan combined with recombinant human brain natriuretic peptide(rhBNP)in the treatment of patients with heart failure with preserved left ventricular ejection fraction(HFpEF)and the changes of peak velocity ratio(E/A)of mitral valve blood flow in early and late diastole by echocardiography.Methods 134 patients with HFpEF admitted to hospital from June 2019 to June 2021 were divided into study group and control group according to random number table,with 67 cases in each group.The control group were given tolvaptan,and the study group were additionally treated with rhBNP on the basis of the control group.And then,the clinical efficacy,adverse reactions,length of hospital stay,bed time,and the left ventricular end diastolic diameter(LVEDd),E/A ratio,and left ventricular posterior wall thickness in diastolic end(LVPWTd)by echocardiography,levels of serum N-terminal pro brain natriuretic peptide(NT-proBNP)and high-sensitivity C-reactive protein(hs-CRP)before and after treatment were compared between the two groups.Results The total efficacy of the study group was higher than that of the control group(P<0.05);the length of hospital stay and bed time in the study group were significantly lower than those in the control group(P<0.05).After treatment,LVEDd,LVPWTd,NT-proBNP,and hs-CRP in the two groups were significantly lower than those before treatment(P<0.05),and the E/A ratio was significantly higher than that before treatment(P<0.05),at the same time,LVEDd,LVPWTd,NT-proBNP,and hs-CRP in the study group were lower than those in the control group(P<0.05),and the E/A ratio was higher than that in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Tolvaptan combined with rhBNP is effective in the treatment of patients with HFpEF,which can increase the E/A ratio by echocardiography,improve left ventricular function,reduce inflammatory reaction,shorten the length of hos

关 键 词：托伐普坦 重组人脑钠肽 左心室射血分数保留型心衰 E/A比值 

分 类 号：R541[医药卫生—心血管疾病]