冻干重组人脑利钠肽联合左西孟旦治疗急性心力衰竭的临床观察

发布时间：2018-04-05 06:11

  本文选题：冻干重组人脑利钠肽　切入点：左西孟旦　出处：《中国药房》2016年08期

【摘要】：目的:观察冻干重组人脑利钠肽联合左西孟旦治疗急性心力衰竭的临床疗效与安全性,考察该联合用药对患者血清尿酸(UA)与脑钠肽(BNP)水平的影响。方法:68例急性心力衰竭患者依据抽签法随机分为观察组与对照组,各34例。两组患者均给予常规治疗,在此基础上对照组患者给予左西孟旦注射液5 ml加入0.9%氯化钠注射液45 ml中持续微泵注射:开始后第1 h内泵注速率为12μg/(kg·min),之后以0.5μg/(kg·min)的速率持续给药23 h;观察组患者在对照组基础上给予冻干重组人脑利钠肽1.5μg/kg静脉冲击,之后以7.5 ng/(kg·min)的速率持续静脉滴注3~7 d。观察两组患者的临床疗效,治疗前后血清UA、BNP与心功能指标的变化,以及用药安全性。结果:治疗后,观察组患者的总有效率(94.11%)显著高于对照组(70.59%),差异有统计学意义(P0.05);观察组患者的血清UA与BNP水平改善程度明显优于对照组,差异有统计学意义(P0.05);观察组患者的每搏输出量与左心室射血分数明显优于对照组,差异有统计学意义(P0.05)。观察组患者的不良反应发生率(2.94%)与对照组(5.88%)比较,差异无统计学意义(P0.05)。结论:冻干重组人脑利钠肽联合左西孟旦治疗急性心力衰竭临床疗效明显、安全性高。
[Abstract]:Aim: to observe the clinical efficacy and safety of freeze-dried recombinant human brain natriuretic peptide combined with levosimendan in the treatment of acute heart failure, and to investigate the effects of the combined therapy on the levels of serum uric acid and brain natriuretic peptide (BNPs) in patients with acute heart failure.Methods 68 patients with acute heart failure were randomly divided into observation group and control group.Both groups were given routine treatment.On this basis, the patients in the control group were treated with 5 ml of levosimendan injection and 45 ml of 0.9% sodium chloride injection: the injection rate was 12 渭 g/(kg / min within 1 h after the beginning of injection, and then the drug was administered at the rate of 0.5 渭 g/(kg / min for 23 h in the observation group.Patients were given intravenous shock of 1. 5 渭 g/kg of recombinant human brain natriuretic peptide on the basis of control group.After that, continuous intravenous drip was given at the rate of 7.5 ng/(kg for 7 d.To observe the clinical effect of the two groups, the changes of serum UABNP and cardiac function indexes before and after treatment, and the safety of medication.Results: after treatment, the total effective rate of patients in the observation group was significantly higher than that in the control group (70.59), the difference was statistically significant (P 0.05), the improvement of serum UA and BNP levels in the observation group was significantly better than that in the control group.The difference was statistically significant (P 0.05), and the stroke output and left ventricular ejection fraction (LVEF) in the observation group were significantly better than those in the control group (P 0.05).There was no significant difference in the incidence of adverse reactions between the observation group (2.94) and the control group (5.88).Conclusion: freeze-dried recombinant human brain natriuretic peptide combined with levosimendan is effective and safe in the treatment of acute heart failure.
【作者单位】： 解放军第117医院心内科;
【分类号】：R541.6
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本文编号：1713511