重组人脑利钠肽辅助治疗老年心力衰竭患者的疗效及其对心功能、炎性指标的影响

重组人脑利钠肽辅助治疗老年心力衰竭患者的疗效及其对心功
能、炎性指标的影响
孙颖;郝艳丽;李延辉;庄媛;李悦
【期刊名称】《疑难病杂志》
【年(卷),期】2017(016)001
【摘要】目的：观察重组人脑利钠肽辅助治疗老年心力衰竭患者的临床疗效及其
对心功能、炎性指标的影响。

方法选取2015年4月—2016年4月辽宁省金秋医院心血管内科收治的心力衰竭患者82例作为研究对象，随机数字表法分为观察组41例和对照组41例，对照组给予常规抗心力衰竭治疗；观察组在对照组基础上
联用重组人脑利钠肽，初始负荷剂量（1．5～2．0）μg／kg，3 min内静脉注射，然后以0．0075μg· kg－1· min－1连续静脉泵入72 h，2组患者均连续治疗7 d；比较2组患者临床疗效；左室射血分数（ LVEF ）、左室收缩末期内径
（ LVESD ）、左室舒张末期内径（LVEDD）、每搏输出量（SV）、心脏指数（CI）；血清脑钠肽（BNP）、C反应蛋白（CRP）含量、血肌酐（SCr）水平；
记录不良反应。

结果观察组总有效率为90．2％，显著高于对照组的73．2％
（χ2＝3．998， P ＝0．046）；与治疗前比较2组患者治疗后LVEF明显提高，LVESD、BNP、CRP、SCr显著降低（ t ＝10．411、4．710、34．623、5．942、3．128，6．593、1．761、19．126、3．732、1．768， P均＜0．05），而LVEDD、SV、CI无明显变化（ t ＝1．089、0．624、1．454，1．391、0．386、0．860， P均＞0．05）；观察组 LVEF、LVESD、BNP、CRP、SCr 改善程度明显优于对照组（ t ＝4．029、3．047、25．666、3．893、1．738， P均＜0．05）；2组患者治疗期间发生体位性低血压、腹痛、头痛、
转氨酶升高、血钾升高等不良反应发生率比较，差异均无统计学意义（χ2＝1．075、0．503、0．193、0．889、0．889， P均＞0．05）。

结论重组人脑利钠肽辅助治疗老年心力衰竭患者能提高临床效果，改善心功能，减轻肾功能损伤和炎性反应，安全可靠，有利于患者的康复，值得临床推广应用。

%Objective To observe the clinical efficacy and changes in heart function , BNP, SCr, CRP of elderly pa-tients with heart failure in treatment with recombinant human brain natriuretic peptide .Methods Eighty-two cases of patients with heart failure in Liaoning Jinqiu Hospital internal medicine department were selected , and they were divided into the ob-servation group (41 cases) and control group (41 cases).The patients of control group were treated with conventional thera-py.On the basis of control group , the patients of observation group were treated with recombinant human brain natriuretic pep -tide ( initial loading dose (1.5 -2.0) μg /kg, intravenously within 3min, then 0.007 5μg.kg-1 .min-1 continuous intrave-nous infusion for 72h).The patients of two groups were all treated for 7 pare the clinical efficacy, adverse events and changes of the levels of left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter ( LVEDD ) , stroke volume ( SV ) , cardiac index ( CI ) , serum brain natriuretic peptide (BNP), C reactive protein (CRP) content, serum creatinine (SCr) of the two groups.Results After the appropriate treat-ment, the patients of the observation group got a total effective rate of 90.2%, which was significantly better than the 73.2%of the control group (χ2 =3.998, P
=0.046); In the terms of LVEF, LVESD, BNP, CRP and SCr, the patients of
two groups were all significantly improved than before ( t =10.411, t
=4.710, t =34.623, t =5.942, t =3.128, t =6.593, t =1.761, t =19.126, t
=3.732, t =1.768, all P <0.05), and the patients of the observation group got more significant improvement ( t =4.029, t =3.047, t =25.666, t =3.893, t =1.738, all P <0.05);In the terms of LVEDD, SV, CI,&nbsp;there were no significant changes than before in both two groups ( t =1.089, t =0.624, t =1.454, t =1.391, t =0.386, t=0.860, t =0.837, t =0.571, t =0.512, all
P >0.05);There were orthostatic hypotension, abdominal pain, headache, elevated aminotransferases , elevated serum potassium and other adverse reactions occurred in both two groups during the treat -ment, and there were no statistically significant between the two g roups (χ2 =1.075,χ2
=0.503,χ2 =0.193,χ2 =0.889,χ2 =0.889, all P >0.05).Conclusion Recombinant human brain natriuretic peptide in adjuvant therapy can improve the clinical effect of elderly patients with heart failure , improve heart function , reduce the renal injury and inflammatory reaction , safe and reliable , is conducive to the rehabilitation of patients , is worthy of clinical application .
【总页数】4页(P10-13)
【作者】孙颖;郝艳丽;李延辉;庄媛;李悦
【作者单位】110016 沈阳，辽宁省金秋医院心血管内科四病房;110016 沈阳，辽宁省金秋医院心血管内科四病房;110016 沈阳，辽宁省金秋医院心血管内科四病房;110016 沈阳，辽宁省金秋医院心血管内科四病房;110016 沈阳，辽宁省金秋医院心血管内科四病房
【正文语种】中文
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