rhBNP联合地尔硫卓治疗对急性心肌梗死合并心力衰竭患者心率变异性及住院期间MACE发生率的影响  

Effect of rhBNP combined with diltiazem on heart rate variability and incidence of MACE in patients with acute myocardial infarction complicated with heart failure during hospitalization

作　　者：李燕[1] 王琰淏 周晓铎 李纲[1] 张松雨[1] 陈珂[2] 姚明杨 LI Yan;YAO Mingyang;LIU Jiangbo;无(Cardiovascular Medicine Department,Nanyang Central Hospital,Henan,Nanyang 473009,China;Cardiovascular Medicine Department,Henan Provincial People's Hospital,Henan,Zhengzhou,450003,China)

机构地区：[1]南阳市中心医院,心血管内科,河南南阳473009 [2]河南省人民医院,心血管内科,河南郑州450003 [3]不详

出　　处：《实验与检验医学》2023年第1期12-16,共5页Experimental and Laboratory Medicine

基　　金：河南省科技计划项目,编号172102310065。

摘　　要：目的探究重组人B型钠尿肽(rhBNP)联合地尔硫卓对急性心肌梗死合并心力衰竭患者心率变异性(HRV)及住院期间不良心血管事件(MACE)发生率的影响。方法将182例急性心肌梗死合并心力衰竭患者随机分为对照组和观察组,对照组给予常规治疗,观察组在对照组基础上给予rhBNP联合地尔硫卓治疗;观察两组临床疗效,比较治疗前后心功能指标、HRV指标及相关实验室指标的变化,并统计患者住院期间MACE发生情况。结果观察组总治疗有效率为89.01%,高于对照组(P<0.05)。治疗后,两组LVEF均高于同组治疗前,LVEDV和LVESV均低于同组治疗前,且观察组LVEF高于对照组,LVEDV和LVESV低于对照组(P<0.05)。治疗后,对照组SDNN、SDANN、RMSSD及PNN50较治疗前均有所提高,仅SDNN和PNN50治疗前后比较有统计学意义(P<0.05);观察组治疗后上述指标均明显高于治疗前,且高于对照组(P<0.05)。治疗后,两组NT-proBNP、hs-CRP及Cr低于同组治疗前,且观察组上述指标低于对照组(P<0.05)。治疗期间,两组患者均未出现明显不良反应;住院期间,观察组MACE发生率为6.59%,低于对照组(P<0.05)。结论rhBNP联合地尔硫卓可明显改善急性心肌梗死合并心力衰竭患者心功能,提高HRV,降低MACE发生率,安全性高。Objective To investigate the effect of recombinant human B-type natriuretic peptide(rhBNP)combined with diltiazem on heart rate variability(HRV)and incidence of adverse cardiovascular events(MACE)in patients with acute myocardial infarction complicated with heart failure during hospitalization.Methods A total of 182 patients with acute myocardial infarction complicated with heart failure were randomized into control group and observation group.The control group was given routine treatment,and the observation group was treated with rhBNP combined with diltiazem on the basis of the control group.The clinical effect was observed.Changes in cardiac function indexes,HRV indexes and related laboratory indexes before and after treatment were compared between the two groups,and the incidence of MACE during hospitalization was statistically analyzed.Results The total effective rate of treatment in the observation group(89.01%)was higher than that in the control group(P<0.05).After treatment,the LVEF increased,while LVEDV and LVESV decreased.Besides,LVEF in the observation group was higher than that in the control group,but LVEDV and LVESV were lower than the control group(P<0.05).After treatment,the SDNN,SDANN,RMSSD and PNN50 in the control group were improved.However,there were statistically significant differences only in SDNN and PNN50 before and after treatment(P<0.05).The above indexes in the observation group after treatment were significantly higher than those before treatment and those in the control group(P<0.05).After treatment,NT-proBNP,hs-CRP and Cr decreased,and the above indexes in the observation group were lower than those in the control group(P<0.05).No obvious adverse reactions occurred in either group during treatment.The incidence rate of MACE in the observation group during hospitalization(6.59%)was lower than that in the control group(P<0.05).Conclusion RhBNP combined with diltiazem can significantly improve the cardiac function of patients with acute myocardial infarction complicated with heart fail

关 键 词：重组人B型钠尿肽 地尔硫卓 急性心肌梗死 心力衰竭 心率变异性 

分 类 号：R542.2[医药卫生—心血管疾病]