重组人脑利钠肽辅助治疗老年重症急性心梗并心力衰竭的效果及对氧化应激指标的影响  

Effect of recombinant human brain natriuretic peptide in the adjuvant treatment of acute myocardial infarction with heart failure in the elderly and its influence on indicators of oxidative stress

作　　者：吴晓兰 WU Xiao-lan(Intensive Care Unit,Linyi Geriatric Hospital,Linyi 276000,China)

机构地区：[1]临沂老年医院重症医学科,276000

出　　处：《中国现代药物应用》2025年第6期72-75,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨在老年重症急性心肌梗死(心梗)并心力衰竭患者中重组人脑利钠肽的辅助治疗效果。方法92例老年重症急性心梗并心力衰竭患者,采用随机数字表法分为对照组和观察组,每组46例。对照组患者接受标准的常规疗法,观察组在对照组基础上使用重组人脑利钠肽辅助治疗。比较两组患者的疗效,治疗前后的心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、氧化应激指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、脂质过氧化物(LPO)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)]及血管内皮功能指标[血流介导的血管舒张功能(FMD)、一氧化氮合酶(NOS)、非对称性二甲基精氨酸(ADMA)、一氧化氮(NO)]水平。结果观察组治疗总有效率91.30%显著高于对照组的76.09%,差异具有统计学意义(P<0.05)。治疗48 h后,两组患者的LVEF、LVEDD、LVESD均较治疗前改善,且观察组的LVEF(53.73±5.85)%高于对照组的(44.41±6.04)%,LVEDD(51.16±3.37)mm、LVESD(31.38±3.59)mm小于对照组的(57.37±3.61)、(34.26±3.86)mm,差异具有统计学意义(P<0.05)。治疗48 h后,两组患者的SOD、CAT、LPO、MDA、GSH-Px均较治疗前改善,且观察组SOD(570.23±52.15)U/L、CAT(270.16±38.72)U/L、GSH-Px(155.16±10.37)U/L高于对照组的(487.76±54.04)、(229.37±38.13)、(103.37±11.61)U/L,LPO(5.07±1.16)μmol/L、MDA(3.73±0.85)μmol/L低于对照组的(6.62±1.08)、(6.41±0.74)μmol/L,差异具有统计学意义(P<0.05)。治疗48 h后,两组患者的FMD、NOS、ADMA、NO均较治疗前改善,且观察组FMD(11.27±1.91)%、NOS(18.31±1.62)μmol/L、NO(79.73±3.72)μmol/L高于对照组的(9.06±1.21)%、(13.24±1.84)μmol/L、(71.26±3.54)μmol/L,ADMA(228.28±14.39)μg/L低于对照组的(246.81±14.59)μg/L,差异具有统计学意义(P<0.05)。结论老年重症急性心梗并心力衰竭患者采用重组人脑利钠肽辅助治疗,能够明显改善心脏功能参数,同Objective To explore the effect of recombinant human brain natriuretic peptide in the adjuvant treatment of acute myocardial infarction with heart failure in the elderly.Methods 92 elderly patients with acute myocardial infarction and heart failure were divided into control group and observation group by random numerical table,with 46 cases in each group.The control group received standard conventional therapy,and the observation group received recombinant human brain natriuretic peptide adjuvant therapy based on the control group.Both groups were compared in terms of efficacy,indicators of cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular endsystolic diameter(LVESD)],indicators of oxidative stress[superoxide dismutase(SOD),catalase(CAT),lipid peroxides(LPO),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and indicators of vascular endothelial function[flow-mediated dilation(FMD),nitric oxide synthase(NOS),asymmetric dimethylarginine(ADMA),nitric oxide(NO)]before and after treatment.Results The total effective rate of 91.30%in the observation group was significantly higher than 76.09%in the control group,and the difference was statistically significant(P<0.05).After 48 h of treatment,LVEF,LVEDD and LVESD in both groups were improved compared with before treatment;the observation group had a higher LVEF of(53.73±5.85)%than(44.41±6.04)%in the control group;the observation group had LVEDD of(51.16±3.37)mm and LVESD of(31.38±3.59)mm,which were smaller than(57.37±3.61)and(34.26±3.86)mm in the control group;the difference was statistically significant (P<0.05). After 48 h of treatment, SOD, CAT, LPO, MDA and GSH-Px in both groups were improved compared with before treatment;the observation group had SOD of (570.23±52.15) U/L, CAT of (270.16±38.72) U/L and GSH-Px of (155.16±10.37) U/L, which were higher than (487.76±54.04), (229.37±38.13) and (103.37±11.61) U/L in the control group;the observation group had LPO of (5.07± 1.16) μmol/

关 键 词：重组人脑利钠肽 老年重症急性心肌梗死 心力衰竭 氧化应激指标 

分 类 号：R541.4[医药卫生—心血管疾病]