重组人脑利钠肽治疗急性失代偿心力衰竭的临床疗效及对炎症因子的影响

发布时间：2018-06-16 23:38

本文选题：重组人脑利钠肽 + 急性失代偿心力衰竭　；参考：《重庆医学》2016年34期

【摘要】：目的观察重组人脑利钠肽(rhBNP)对急性失代偿心力衰竭(ADHF)患者的临床疗效和对心功能及炎症因子的影响。方法选取2014年1月到2015年7月在该院心内科诊断为ADHF患者69例。在常规治疗基础上按照给予rhBNP或硝普钠分为rhBNP组(n=37)和硝普钠组(n=32)。观察两组的临床疗效和用药后2h、48h、7d心率和收缩压变化,并比较两组用药后7d左室舒张末内径(LVEDD)及左室射血分数(LVEF)变化、血浆N末端脑钠肽原(NT-proBNP)、高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)水平。结果 rhBNP组总有效率显著高于硝普钠组(89.2%vs.68.8%,P0.05);与用药前相比,用药后2h、48h和7d两组心率和收缩压均显著降低(P0.01),用药后2h,rhBNP组心率和收缩压显著低于硝普钠组(P0.01);与用药前相比,两组血浆NT-proBNP、hs-CRP和IL-6水平均显著降低(P0.01),用药后7drhBNP组血浆NT-proBNP、hs-CRP和IL-6的水平显著低于硝普钠组(P0.01);与用药前相比,两组LVEDD降低,LVEF均显著提高(P0.01),而且用药后7drhBNP组的LVEF水平显著高于硝普钠组(P0.01)。结论 rhBNP治疗急性失代偿心力衰竭的临床疗效优于硝普钠,并且rhBNP改善心功能,具有更强的抗炎作用。
[Abstract]:Objective to observe the effect of recombinant human brain natriuretic peptide rhBNPon on heart function and inflammatory factors in patients with acute decompensated heart failure (ADHFV). Methods 69 patients with ADHF were selected from January 2014 to July 2015. On the basis of routine therapy, we divided rhBNP or sodium nitroprusside into two groups: rhBNP group (n = 37) and sodium nitroprusside group (n = 32). The clinical efficacy and the changes of heart rate and systolic blood pressure (SBP) and left ventricular end-diastolic diameter (LVEDDD) and left ventricular ejection fraction (LVEF) in the two groups were observed at 2 h and 48 h after treatment respectively, and the changes of left ventricular end-diastolic diameter (LVEDDD) and left ventricular ejection fraction (LVEF) were compared between the two groups. Plasma N-terminal brain natriuretic peptide (NT-proBNPP, Gao Min C-reactive protein hs-CRP) and interleukin-6 (IL-6). Results the total effective rate of rhBNP group was significantly higher than that of sodium nitroprusside group (89.2vs.68.8), the heart rate and systolic pressure of rhBNP group were significantly lower than those of sodium nitroprusside group (P 0.01), and the heart rate and systolic pressure of rhBNP group were significantly lower than those of sodium nitroprusside group at 2 h and 7 d after administration, compared with those before administration, the total effective rate of rhBNP group was significantly higher than that of sodium nitroprusside group (P 0.01). The plasma levels of NT-proBNPhs-CRP and IL-6 in both groups were significantly lower than those in sodium nitroprusside group (P 0.01), and the LVEF of LVEDD decreased significantly in both groups compared with that before treatment, and the LVEF level of 7 drhBNP group was significantly higher than that of sodium nitroprusside group (P 0.01) after 7 drhBNP treatment, and the level of LVEF in 7 drhBNP group was significantly higher than that in sodium nitroprusside group (P 0.01). Conclusion rhBNP is superior to sodium nitroprusside in the treatment of acute decompensated heart failure, and rhBNP improves cardiac function and has stronger anti-inflammatory effect.
【作者单位】：山西省大同市第三人民医院心内科;
【分类号】：R541.6

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