左西孟旦与重组人脑利钠肽治疗AMI急诊PCI术后患者短期临床疗效的对比

发布时间：2018-10-10 13:11

【摘要】：目的:探讨静脉应用左西孟旦与重组人脑利钠肽治疗急性前壁心肌梗死急诊经皮冠状动脉介入治疗(PCI)术后患者的短期临床疗效。方法:94例急性前壁心肌梗死急诊PCI术后的患者,随机分为左西孟旦组(51例)和重组人脑利钠肽组(43例),观察两组治疗7d前后脑利钠肽(BNP)、左室射血分数(LVEF)、肌酐水平和治疗前后24h、48h、72h尿量变化情况及低血压、室性心动过速(室速)、心脏破裂发生情况。结果:两组治疗后7d的血浆BNP水平较同组治疗前显著降低(P0.01),重组人脑利钠肽组BNP值显著低于左西孟旦组(P0.01);两组治疗后7d的LVEF较同组治疗前显著升高(P0.05),左西孟旦组LVEF值显著高于重组人脑利钠肽组(P0.01);两组治疗后7d的血清肌酐水平较同组治疗前显著降低(P0.01),重组人脑利钠肽组与左西孟旦组的差异无统计学意义(P0.05);两组治疗后24、48、72h的24h尿量均较同组治疗前显著增多(P0.01);治疗后48、72h的24h尿量,重组人脑利钠肽组显著高于左西孟旦组(P0.01),但治疗后24h尿量无统计学差异(P0.05)。重组人脑利钠肽组低血压发生率高于左西孟旦组(P0.05);左西孟旦组室速的发生率高于重组人脑利钠肽组(P0.05);重组人脑利钠肽组与左西孟旦组心脏破裂发生率差异无统计学意义(P0.05)。结论:左西孟旦较重组人脑利钠肽能更好地提高LVEF,改善左心室收缩功能。左西孟旦和重组人脑利钠肽均具有肾脏保护作用,重组人脑利钠肽利尿效果及降低BNP值均优于左西孟旦。
[Abstract]:Objective: to investigate the short-term clinical effect of intravenous levosimendan and recombinant human brain natriuretic peptide (BNP) in the treatment of acute anterior myocardial infarction (AMI) by percutaneous coronary intervention (PCI). Methods: 94 cases of acute anterior wall myocardial infarction after emergency PCI operation, The left ventricular ejection fraction (LVEF),) of brain natriuretic peptide (BNP),) was observed after 7 days of treatment and the changes of urine volume and hypotension were observed before and after treatment for 24 h, 48 h and 72 h before and after treatment, and the patients were randomly divided into two groups: the left ventricular ejection fraction (LVEF),) of brain natriuretic peptide (BNP),) was measured 7 days before and after treatment. Ventricular tachycardia (ventricular tachycardia), the occurrence of heart rupture. Results: the plasma BNP level in both groups was significantly lower than that in the same group 7 days after treatment (P0.01), the BNP value of recombinant human brain natriuretic peptide group was significantly lower than that of levosimendan group (P0.01), and the LVEF of both groups was significantly higher than that of the same group 7 days after treatment (P0.05), while that of levosimendan group was significantly higher than that of control group (P0.01). The serum creatinine level in the two groups was significantly lower than that in the same group 7 days after treatment (P0.01), but there was no significant difference between the recombinant human brain natriuretic peptide group and the levosimendan group (P0.05). 24 hours urine volume was significantly higher than that of the same group before treatment (P0.01), and the 24h urine volume of 48 minutes 72 hours after treatment was significantly higher than that of the same group (P0.01). The recombinant human brain natriuretic peptide group was significantly higher than that of levosimendan group (P0.01), but there was no significant difference in urine volume 24 hours after treatment (P0.05). The incidence of hypotension in the recombinant human brain natriuretic peptide group was higher than that in the levosimendan group (P0.05); the incidence of ventricular tachycardia was higher in the levosimendan group than in the recombinant human brain natriuretic peptide group (P0.05); there was no significant difference in the incidence of cardiac rupture between the recombinant human brain natriuretic peptide group and the levosimendan group (P0.05). Conclusion: compared with recombinant human brain natriuretic peptide, left ventricular systolic function can be improved by LVEF,. Both levosimendan and recombinant human brain natriuretic peptide had renal protective effects, and the diuretic effect of recombinant human brain natriuretic peptide and the decrease of BNP value were superior to those of levosimendan.
【作者单位】：胜利油田中心医院心血管内科;
【分类号】：R542.22

【相似文献】