重组人脑利钠肽联合多巴胺对重症心衰患者CysC、Hcy及心功能的影响  

Effect of recombinant human natriuretic peptide combined with dopamine on CysC,Hcy and cardiac function in patients with severe heart failure

作　　者：孟锐[1] 李向楠[1] 刘慧敏[1] 易忠[1] MENG Rui;LI Xiang-nan;LIU Hui-min;YI Zhong(First Department of Geriatrics,Aerospace Center Hospital,Beijing,100049,China)

机构地区：[1]航天中心医院老年医学一科,北京100049

出　　处：《心血管康复医学杂志》2025年第2期221-225,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究重组人脑利钠肽(rhBNP)联合多巴胺对重症心力衰竭(HF)患者心功能、胱抑素C(Cys C)和同型半胱氨酸(Hcy)的影响。方法:选择2021年12月至2022年12月期间航天中心医院收治的110例重症HF患者纳入研究,采用随机数字表法分为联合治疗组和对照组,每组55例。所有患者入院后均接受基础治疗,同时对照组予以硝酸甘油联合多巴胺治疗,联合治疗组予以rhBNP联合多巴胺治疗;两组均治疗1周。对比两组治疗效果、CysC、Hcy水平和左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)和左心室射血分数(LVEF),及不良反应发生率。结果:与对照组比较,联合治疗组总有效率(81.82%比58.18%)、LVEF[(54.68±4.59)%比(44.79±4.37)%]显著提高,CysC[(1.02±0.19)mg/L比(1.40±0.21)mg/L]、Hcy[(15.98±2.17)μmol/L比(21.05±2.82)μmol/L]、LVESd[(35.13±3.51)mm比(41.71±3.28)mm]和LVEDd[(41.33±4.26)mm比(50.51±4.37)mm]均显著降低(P均<0.01)。两组总不良反应发生率对比差异无统计学意义(16.36%比7.27%,P=0.140)。结论:rhBNP联合多巴胺治疗重症HF可显著提升临床治疗效果,改善其Cys C、Hcy水平和心功能,且安全性较好。Objective:To explore the effect of recombinant human brain natriuretic peptide(rhBNP)combined with dopamine on cystatin C(CysC),homocysteine(Hcy)and cardiac function in patients with severe heart failure(HF).Methods:This randomized controlled study enrolled 110 severe HF patients admitted in Aerospace Center Hospital between December 2021 and December 2022.They were divided into control group(n=55,nitroglycerin combined dopamine)and combined treatment group(n=55,rhBNP combined dopamine).Each group received corresponding therapy based on basic treatment for one week.Therapeutic effect,levels of CysC,Hcy,left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),and incidence of adverse reactions were compared between two groups.Results:Compared with patients in control group,those in combined treatment group had significant higher total effective rate(81.82%vs.58.18%)and LVEF[(54.68±4.59)%vs.(44.79±4.37)%],and significant lower CysC[(1.02±0.19)mg/L vs.(1.40±0.21)mg/L],Hcy[(15.98±2.17)μmol/L vs.(21.05±2.82)μmol/L],LVESd[(35.13±3.51)mm vs.(41.71±3.28)mm]and LVEDd[(41.33±4.26)mm vs.(50.51±4.37)mm](P<0.01 all).There was no significant difference in total incidence of adverse reactions between two groups(16.36%vs.7.27%,P=0.180).Conclusion:rhBNP combined with dopamine could significantly improve the clinical therapeutic effect,improve levels of CysC,Hcy and cardiac function with good safety in the treatment of severe HF.

关 键 词：心力衰竭 重组人脑利钠肽 多巴胺药 

分 类 号：R541.61[医药卫生—心血管疾病]