重组人脑利钠肽在心肾综合征患者冠状动脉介入治疗围手术期的临床疗效  

Clinical efficacy of rhBNP in perioperative period of coronary intervention in patients with cardio-renal syndrome

作　　者：白凤琪 唐冰鑫 赵志强[1] BAI Feng-qi;TANG Bing-xin;ZHAO Zhi-qiang(Department of Cardiology,The Second Hospital,Tianjin Medical University,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院心脏科,天津市心血管病离子与分子机能重点实验室,天津心脏病学研究所,天津300211

出　　处：《天津医科大学学报》2023年第5期476-480,共5页Journal of Tianjin Medical University

基　　金：天津市医学重点学科(专科)建设项目资助(TJYXZDXK-029A);天津市卫生健康委员会科技项目资助(ZC20143)。

摘　　要：目的:探讨需要接受冠状动脉介入治疗的心肾综合征患者围手术期使用冻干重组人脑利钠肽(新活素)的临床疗效。方法:回顾性分析2018年1月—2022年6月就诊于天津医科大学第二医院接受冠状动脉介入治疗的100例心肾综合征患者的临床和实验室数据,根据围手术期是否使用新活素分为常规治疗组(43例)和常规治疗+新活素组(57例),所有两组均接受水化治疗。分别评估两组患者入院时和术后72 h的血尿素氮(BUN)、血肌酐(SCr)、估算的肾小球滤过率(eGFR)以及N-末端脑钠肽前体(NT-proBNP)。结果:与常规治疗组比,常规治疗+新活素组术后72h BUN、SCr、NT-proBNP都较术前明显降低[3.20(1.30,5.80)vs.1.40(-0.80,3.10)mmol/L,Z=-2.810,P<0.05;19.40(6.50,39.30)vs.-8.60(-28.70,27.50)μmol/L,Z=-3.815,P<0.001;1221.45(175.66,2381.60)vs.-182.45(-1379.90,-27.00)mmol/L,Z=-0.337,P<0.001],而eGFR较前明显升高[4.26(0.59,8.23)vs.-1.42(-3.80,4.59)mL/(min·1.73 m)2,Z=-4.042,P<0.001];多元线性回归分析发现,新活素是接受冠状动脉介入治疗的心肾综合征患者心功能的保护因素(β=0.384,P<0.0001),同时也是肾功能的保护因素(β=0.322,P<0.01)。结论:新活素能有效改善接受冠状动脉介入治疗的心肾综合征患者术后的心、肾功能。Objective:To explore the clinical efficacy of lyophilized recombinant human brain natriuretic peptide(rhBNP)in patients with cardiorenal syndrome undergoing coronary intervention during the perioperative period.Methods:The clinical and laboratory data of 100 cardiorenal syndrome patients who underwent coronary intervention at the Second Hospital of Tianjin Medical University from January 2018 to June 2022 were retrospectively analyzed.Patients were divided into two groups based on whether rhBNP was used during the perioperative period:conventional treatment group(43 cases)and conventional treatment plus rhBNP group(57 cases).Both groups received hydration therapy.We evaluated the laboratory indicators upon admission and the cardiorenal function indicators at 72 hours postoperatively,including blood urea nitrogen(BUN),serum creatinine(SCr),estimated glomerular filtration rate(eGFR),and Nterminal pro-brain Natriuretic peptide(NT-proBNP).Results:Compared to the conventional treatment group,BUN,SCr,and NTproBNP were significantly reduced in the conventional treatment plus rhBNP group at 72 hours postoperatively[reduction in BUN:3.20(1.30,5.80)vs.1.40(-0.80,3.10)mmol/L,Z=-2.810,P<0.05;reduction in SCr:19.40(6.50,39.30)vs.-8.60(-28.70,27.50)μmol/L,Z=-3.815,P<0.001;reduction in NT-proBNP:1221.45(175.66,2381.60)vs.-182.45(-1379.90,-27.00)mmol/L,Z=-0.337,P<0.001],while eGFR significantly increased[4.26(0.59,8.23)vs.-1.42(-3.80,4.59)mL/(min·1.73 m2),Z=-4.042,P<0.001].Multivariate linear regression analysis revealed that rhBNP treatment was a protective factor for cardiorenal function in cardiorenal syndrome patients undergoing coronary intervention(β=0.384,P<0.0001),and also a protective factor for renal function(β=0.322,P<0.01).Conclusion:RhBNP can effectively improve the postoperative cardiorenal function in patients with cardiorenal syndrome undergoing coronary intervention.

关 键 词：重组人脑利钠肽 心肾综合征 冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]