米力农联合rhBNP在充血性心力衰竭治疗中的应用价值  

Application value of milrinone combined with rhBNP in the treatment of congestive heart failure

作　　者：王薪雅 廖鸿洋 王倩 钟倩 陈旖旎 WANG Xinya;LIAO Hongyang;WANG Qian;ZHONG Qian;CHEN Yini(CCU,The Third People's Hospital of Chengdu,Chengdu 610031,China;Department of Cardiology,The Third People's Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院CCU,四川成都610031 [2]成都市第三人民医院心内科,四川成都610031

出　　处：《西部医学》2023年第3期444-448,共5页Medical Journal of West China

基　　金：四川省卫生健康科研课题普及项目(19PJ168)。

摘　　要：目的基于心肌纤维化情况及血液流变学改变探究米力农联合重组人脑利钠肽(rhBNP)在充血性心力衰竭(CHF)治疗中的应用价值。方法选取2019年1月—2021年1月我院收治的CHF患者119例,经随机数表法分为联合组(n=60)与对照组(n=59)。对照组在常规治疗基础上加用米力农治疗,联合组在对照组基础上加用rhBNP治疗。比较两组患者治疗前、治疗7 d后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心脏指数(Cardiac index,CI)、心输出量(CO)]、血液流变学[血浆黏度(PV)、纤维蛋白原(FIB)、血小板聚集率(PAR)]、心衰指标[氨基端前B型钠尿肽(NT-proBNP)、同型半胱氨酸(Hcy)]、心肌纤维化指标[Ⅰ型前胶原羧基端肽(PICP)、Ⅲ型前胶原氨基端肽(PⅢNP)]水平,统计两组患者治疗7 d内不良反应发生情况。结果治疗7 d后,两组患者部分心功能指标(LVEF、CI、CO)水平显著高于治疗前,且联合组显著高于对照组(均P<0.05);两组患者LVEDD、PV、心衰指标(NT-proBNP、Hcy)、心肌纤维化指标(PICP、PⅢNP)水平显著低于治疗前,且联合组显著低于对照组(均P<0.05);联合组血液流变学部分指标(FIB、PAR)水平显著低于治疗前,且FIB水平显著低于对照组(均P<0.05),PAR水平两组比较无统计学差异(P>0.05),对照组FIB、PAR水平与治疗前无统计学差异(均P>0.05)。治疗7 d内,两组患者不良反应发生情况无统计学差异(P>0.05)。结论米力农与rhBNP联合治疗在调节患者心脏功能与血液流变学水平方面有积极作用,具有一定临床应用价值。Objective To explore the application value of milrinone combined with rhBNP in the treatment of congestive heart failure(CHF)based on myocardial fibrosis and hemorheological changes.Methods 119 patients with CHF treated in the hospital were selected from January 2019 to January 2021,and were divided into combined group(n=60)and control group(n=59)by the random number table method.The control group was additionally treated with milrinone on the basis of conventional treatment,while the combined group was additionally given rhBNP on the basis of the control group.The cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),cardiac index(CI),cardiac output(CO)],hemorheology[plasma viscosity(PV),fibrinogen(FIB),platelet aggregation rate(PAR)],heart failure indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),homocysteine(Hcy)]and myocardial fibrosis indicators[carboxyterminal propeptide of type I procollagen(PICP),aminoterminal propeptide of type III procollagen(PIIINP)]were compared between the two groups before treatment and after 7 d of treatment.The occurrence of adverse reactions in the two groups within 7 d of treatment were statistically analyzed.Results After 7 d of treatment,the levels of partial cardiac function indicators(LVEF,CI,CO)in the two groups were significantly higher than those before treatment,and the above indicators in combined group were significantly higher than those in control group(all P<0.05).The levels of LVEDD,PV,heart failure indicators(NT-proBNP,Hcy)and myocardial fibrosis indicators(PICP,PIIINP)were significantly lower in the two groups than those before treatment,and the levels were significantly lower in combined group than those in control group(all P<0.05).The levels of partial indicators of hemorheology(FIB,PAR)in combined group were significantly lower than those before treatment,and the level of FIB was significantly lower than that in control group(all P<0.05),and there was no statistical difference in PAR l

关 键 词：米力农 RHBNP 充血性心力衰竭 心肌纤维化 NT-PROBNP HCY 

分 类 号：R541.61[医药卫生—心血管疾病]