rhBNP联合沙库巴曲缬沙坦对冠心病合并心力衰竭患者血脂、血流动力学及预后的影响  

Influence of rhBNP combined with sacubitril valsartan on blood lipids,hemodynamics and prognosis in patients with coronary heart disease and heart failure

作　　者：任智敏[1] 陈华 REN Zhi-min;CHEN Hua(Department of Cardiovascular Medicine,Rugao People's Hospital,Rugao,Jiangsu,226500,China)

机构地区：[1]如皋市人民医院心血管内科,江苏如皋226500

出　　处：《心血管康复医学杂志》2024年第6期734-738,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:分析重组人脑利钠肽(rhBNP)联合沙库巴曲缬沙坦对冠心病合并心力衰竭患者血脂、血流动力学及预后的影响。方法:选择2018年7月至2021年7月如皋市人民医院收治的冠心病合并心力衰竭患者130例,采用随机数字表法分为对照组(n=65,rhBNP治疗)和联合治疗组(n=65,在对照组的基础上联合沙库巴曲缬沙坦治疗),疗程3个月。比较两组血脂、血流动力学指标、总有效率及不良反应发生情况,以及随访6个月的预后情况。结果:联合治疗组总有效率显著高于对照组(90.77%比70.77%,P=0.004)。治疗3个月后,与对照组比较,联合治疗组总胆固醇(TC)[(4.05±0.96)mmol/L比(2.97±0.93)mmol/L]、甘油三酯(TG)[(1.75±0.52)mmol/L比(1.12±0.23)mmol/L]、低密度脂蛋白胆固醇(LDL-C)[(3.05±0.99)mmol/L比(2.54±0.72)mmol/L]水平及平均动脉压(MAP)[(94.73±9.23)mmol/L比(85.64±8.25)mmol/L]、心率[(91.32±7.90)次/min比(82.34±8.58)次/min]均显著降低,高密度脂蛋白胆固醇(HDL-C)[(3.12±0.93)mmol/L比(4.10±1.00)mmol/L]显著升高(P均<0.001)。联合治疗组不良反应发生率(13.85%比33.85%)和预后不良发生率(26.15%比55.38%)均显著低于对照组(P均<0.01)。结论:重组人脑利钠肽联合沙库巴曲缬沙坦治疗可以改善冠心病合并心力衰竭患者血脂水平以及血流动力学,降低预后不良发生率,效果显著。Objective:This study aims to analyze the influence of recombinant human brain natriuretic peptide(rhBNP)combined with sacubitril valsartan on blood lipids,hemodynamics and prognosis in patients with coronary heart disease(CHD)and heart failure(HF).Methods:This randomized controlled study enrolled 130 CHD+HF patients admitted in Rugao People's Hospital between July 2018 and July 2021.They were divided into control group(n=65,rhBNP therapy)and combined treatment group(n=65,additional sacubitril valsartan therapy based on control group),and treated for 3 months.Blood lipids,hemodynamic indexes,total effective rate,incidence of adverse reactions,prognosis after 6-month follow-up were compared between two groups.Results:The total effective rate of combined treatment group was significantly higher than that of control group(90.77%vs.70.77%,P=0.004).Compared with patients in control group after 3-month treatment,those in combined treatment group had significant lower levels of total cholesterol(TC)[(4.05±0.96)mmol/L vs.(2.97±0.93)mmol/L],triglyceride(TG)[(1.75±0.52)mmol/L vs.(1.12±0.23)mmol/L],low density lipoprotein cholesterol(LDL-C)[(3.05±0.99)mmol/L vs.(2.54±0.72)mmol/L],mean arterial pressure(MAP)[(94.73±9.23)mmol/L vs.(85.64±8.25)mmol/L]and heart rate[(91.32±7.90)beats/min vs.(82.34±8.58)beats/min],and significant higher high density lipoprotein cholesterol(HDL-C)level[(3.12±0.93)mmol/L vs.(4.10±1.00)mmol/L](P<0.001 all).Incidence of adverse reactions(13.85%vs.33.85%)and poor prognosis(26.15%vs.55.38%)in combined treatment group were significantly lower than those of control group(P<0.01 both).Conclusion:Recombinant human brain natriuretic peptide combined with sacubitril valsartan may improve blood lipid levels and hemodynamics,reduce incidence of poor prognosis with significant effects in patients with coronary heart disease and heart failure.

关 键 词：冠心病 心力衰竭 重组人脑利钠肽 沙库巴曲缬沙坦 

分 类 号：R541.4[医药卫生—心血管疾病]