注射用重组人脑利钠肽联合尼可地尔治疗老年缺血性心肌病心力衰竭的临床疗效分析  

Analysis of clinical efficacy of recombinant human brain natriuretic peptide for injection combined with nicorandil in the treatment of heart failure in elderly patients with ischemic cardiomyopathy

作　　者：毕小容 邓君 裴海峰 李德 Bi Xiaorong;Deng Jun;Pei Haifeng;Li De(Department of Cardiovascular Medicine,General Hospital of Western Theater Command of Chinese People's Liberation Army,Chengdu,Sichuan,610083,P.R.China)

机构地区：[1]中国人民解放军西部战区总医院心血管内科,四川成都610083

出　　处：《老年医学与保健》2023年第5期937-941,共5页Geriatrics & Health Care

基　　金：四川省科技计划项目(2015JY0277)。

摘　　要：目的探讨注射用重组人脑利钠肽(rh-BNP)联合尼可地尔治疗老年缺血性心肌病(ICM)心力衰竭的疗效,为治疗该病症提供方法。方法选取2019年12月—2022年12月中国人民解放军西部战区总医院收治的181例老年ICM心力衰竭患者为研究对象,采用数表法随机分为对照组(46例)、rh-BNP组(45例)、尼可地尔组(45例)、干预组(45例)。对照组采用常规方案治疗,rh-BNP组采用rh-BNP治疗,尼可地尔组采用尼可地尔治疗,干预组采用rh-BNP联合尼可地尔治疗,4组均治疗2周。比较4组的临床疗效、心室重构[左室后壁厚度(LVPWT)、左心室后壁收缩末期厚度(PWS)、左心室后壁舒张末期厚度(PWD)]指标值、心肌损伤[可溶性ST2受体(sST2)和N末端脑利钠肽原(NT-proBNP)]指标值、内分泌激素[内皮素-1(ET-1)、醛固酮(ALD)和血管紧张素Ⅱ(AngⅡ)]指标值,以及治疗期间的不良反应。结果治疗后,干预组总有效率高于rh-BNP组、尼可地尔组、对照组(P<0.05);治疗后,4组LVPWT、PWS、PWD、sST2、NT-proBNP、ET-1、ALD及AngⅡ水平均低于同组治疗前(P<0.05),且干预组低于其他3组(P<0.05);治疗期间,4组均未见严重不良反应。结论rh-BNP联合尼可地尔治疗老年ICM患者心力衰竭,可增强临床疗效,抑制心室重构,降低心肌损伤,改善内分泌激素,且安全性好,具有一定的临床应用价值。Objective To explore the efficacy of recombinant human brain natriuretic peptide(rh-BNP)for injection combined with nicorandil in the treatment of heart failure in elderly patients with ischemic cardiomyopathy(ICM),and provide a method for the treatment of this disease.Methods A total of 181 elderly ICM patients with heart failure admitted to General Hospital of Western Theater Command of Chinese People s Liberation Army from December 2019 to December 2022 were selected as the study subjects.According to random number table method,they were randomly divided into control group(46 cases),rh-BNP group(45 cases),nicorandil group(45 cases)and intervention group(45 cases).The control group was treated with conventional regimens,the rh-BNP group was treated with rh-BNP,the nicorandil group was treated with nicorandil,and the intervention group was treated with rh-BNP combined with nicorandil.All were treated for 2 weeks.The clinical curative efficiency,ventricular remodeling indexes[left ventricular posterior wall thickness(LVPWT),left ventricular posterior wall end-systolic thickness(PWS),left ventricular posterior wall end-diastolic thickness(PWD)],myocardial injury indexes[soluble ST2 receptor(sST2),N-terminal pro-brain natriuretic peptide(NT-proBNP)]and endocrine hormones[endothelin-1(ET-1),aldosterone(ALD),angiotensinⅡ(AngⅡ)],as well as adverse reactions during treatment were compared among the four groups.Results After treatment,the total effective rate of the intervention group was higher than that of other three groups(P<0.05).After treatment,the levels of LVPWT,PWS,PWD,sST2,NT proBNP,ET-1,ALD and AngⅡof the four groups were lower than those of the same group before treatment(P<0.05),and the intervention group was lower than other three groups(P<0.05).During treatment,no serious adverse reactions were observed in all 4 groups.Conclusion The combination of rh-BNP and nicorandil in the treatment of heart failure in elderly ICM patients can enhance clinical efficacy,inhibit ventricular remodeling,reduce myoca

关 键 词：老年 缺血性心肌病 心力衰竭 注射用重组人脑利钠肽 尼可地尔 

分 类 号：R541.6[医药卫生—心血管疾病] R542.2[医药卫生—内科学]