冻干重组人脑利钠肽联合呋塞米治疗急性心力衰竭伴肾功能不全的临床效果  

Clinical efficacy of freeze-dried recombinant human brain natriuretic peptide combined with furosemide in the treatment of acute heart failure with renal insufficiency

作　　者：何晓胜 沈佳佳 王顺利 许振 刘淼[1] HE Xiaosheng;SHEN Jiajia;WANG Shunli;XU Zhen;LIU Miao(Department of Cardiovascular Medicine Ⅱ,Puyang People's Hospital,Puyang Henan 457400,China)

机构地区：[1]濮阳市人民医院心血管内科二病区,河南濮阳457400

出　　处：《天津药学》2025年第3期274-277,281,共5页Tianjin Pharmacy

摘　　要：目的探讨冻干重组人脑利钠肽联合呋塞米治疗急性心力衰竭伴肾功能不全的临床效果。方法选取2020年3月至2023年7月濮阳市人民医院收治的96例急性心力衰竭伴肾功能不全患者,按照随机数字表法分为实验组和对照组,各48例。对照组予以呋塞米,实验组予以呋塞米联合冻干重组人脑利钠肽。对比两组疗效、肾功能[尿素氮(BUN)、肌酐(CREA)]、尿量、血钾、血钠、心功能[6 min步行距离(6MWD)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、神经内分泌因子[血管紧张素Ⅱ(AngⅡ)、内皮素(ET)、心房钠尿肽(ANP)]水平、不良反应。结果实验组总有效率[91.67%(44/48)]较对照组[75.00%(36/48)]高(P<0.05);治疗后,实验组BUN[(10.35±4.67)mmol/L]、CREA[(126.47±95.35)μmol/L]水平较对照组[(13.97±6.04)mmol/L、(175.35±124.02)μmol/L]低(P<0.05);治疗后,实验组尿量[(2103.01±125.36)mL]、血钾[(4.25±0.61)mmol/L]、血钠[(149.26±9.05)mmol/L]较对照组[(1359.24±87.98)mL、(3.28±0.53)mmol/L、(135.71±8.67)mmol/L]高(P<0.05);治疗后,实验组6MWD[(382.45±60.02)m]较对照组[(327.25±57.35)m]远,LVEDD[(21.56±9.18)mm]、LVESD[(35.34±6.04)mm]水平较对照组[(27.37±9.86)mm、(41.39±7.35)mm]低(P<0.05);治疗后,实验组AngⅡ[(100.35±7.25)ng/mL]、ET[(48.62±3.17)ng/L]、ANP[(243.54±12.49)ng/L]水平较对照组[(117.53±8.47)ng/mL、(61.48±3.53)ng/L、(314.73±14.25)ng/L]低(P<0.05);两组不良反应发生率对比无显著差异(P>0.05)。结论呋塞米联合冻干重组人脑利钠肽治疗急性心力衰竭伴肾功能不全患者效果确切,可改善肾功能,促进心功能恢复,调节神经内分泌因子指标,且安全性较佳。Objective To explore the clinical efficacy of freeze-dried recombinant human brain natriuretic peptide and furosemide in the treatment of acute heart failure with renal insufficiency.Methods A total of 96 patients with acute heart failure and renal insufficiency treated at Puyang People's Hospital from March 2020 to July 2023 were divided into the experimental group and the control group according to the random number table method,with 48 patients in each group.The control group was given furosemide,while the experimental group was given furosemide combined with freeze-dried recombinant human brain natriuretic peptide.The efficacy,renal function[blood urea nitrogen(BUN),creatinine(CREA)],urine output,blood potassium,blood sodium,cardiac function[6-minute walking distance(6MWD),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)],levels of neuroendocrine factors[angiotensinⅡ(AngⅡ),endothelin(ET),atrial natriuretic peptide(ANP)],and adverse reactions were compared between two groups.Results The total effective rate of the experimental group[91.67%(44/48)]was higher than that of the control group[75.00%(36/48)](P<0.05);After treatment,the levels of BUN[(10.35±4.67)mmol/L]and CREA[(126.47±95.35)μmol/L]in the experimental group were lower than those in the control group[(13.97±6.04)mmol/L and(175.35±124.02)μmol/L](P<0.05);After treatment,the urine output[(2103.01±125.36)mL],blood potassium[(4.25±0.61)mmol/L],and blood sodium[(149.26±9.05)mmol/L]in the experimental group were higher than those in the control group[(1359.24±87.98)mL,(3.28±0.53)mmol/L,and(135.71±8.67)mmol/L](P<0.05);After treatment,6MWD of the experimental group was[(382.45±60.02)m],which was significantly higher than that of the control group[(327.25±57.35)m],while the levels of LVEDD[(21.56±9.18)mm]and LVESD[(35.34±6.04)mm]were lower than those of the control group[(27.37±9.86)mm and(41.39±7.35)mm](P<0.05);After treatment,the levels of AngⅡ[(100.35±7.25)ng/mL],ET[(48.62±3.17)ng/L],and A

关 键 词：急性心力衰竭 呋塞米 冻干重组人脑利钠肽 肾功能不全 

分 类 号：R541.6[医药卫生—心血管疾病]