重组人脑利钠肽治疗老年急性左心衰病人的效果及对心肌损伤标志物水平的影响

doi:10.3969/j.issn.1003-9198.2022.10.016

摘要/Abstract

摘要： 目的研究重组人脑利钠肽(rhBNP)治疗老年急性左心衰病人的疗效及对心肌损伤标志物水平的影响。方法选取2016年11月至2019年11月入住我院的80例急性左心衰病人为研究对象,随机分为观察组与对照组,每组各40例。2组入院后均行常规治疗,观察组在常规治疗基础上加用rhBNP,对照组在常规治疗基础上加用硝酸甘油。比较2组治疗后临床疗效、治疗前后心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、LVEF、左室短轴缩短率(LVFS)]、损伤标志物水平[肌酸激酶(CK)、乳酸脱氢酶(LDH)、N末端脑利钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)]以及不良反应发生率。结果观察组心功能改善总有效率显著高于对照组,差异有统计学意义(P＜0.05);与治疗前比较,治疗后2组LVESD、LVEDD显著降低,LVEF、LVFS显著升高(均P＜0.05),且观察组改善更显著(均P＜0.05);与治疗前比较,治疗后2组cTnI、CK、LDH、NT-proBNP水平均显著降低(P＜0.05),且观察组降得更低(P＜0.05);观察组不良反应发生率显著低于对照组,差异有统计学意义(P＜0.05)。结论 rhBNP用于老年急性左心衰病人的治疗可显著提升治疗效果,改善心功能,减轻心脏负荷,改善心肌损伤标志物水平,且不良反应较少,有一定推广价值。

关键词: 重组人脑利钠肽, 老年人, 急性左心衰, 心肌损伤

Abstract: Objective To study the effect of recombinant human brain natriuretic peptide (rhBNP) on the levels of myocardial injury markers in the elderly patients with acute left heart failure. Methods From November 2016 to November 2019, 80 patients with acute left heart failure in our hospital were enrolled. They were randomly divided into the observation group and the control group, with 40 cases in each group. Both groups received routine treatment after admission. The observation group was treated with rhBNP, and the control group was treated with nitroglycerin additionally. The clinical efficacy, cardiac function indexes [ left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (LVFS) ], myocardial injury markers [ creatine kinase (CK), lactate dehydrogenase (LDH), N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) ] and the incidence of adverse reactions were compared between the two groups after treatment. Results The total effective rate of cardiac function improvement in the observation group was significantly higher than that in the control group(P＜0.05).The levels of LVESD and LVEDD in the two groups after treatment were significantly lower than those before treatment, while the levels of LVEF and LVFS were significantly higher than those before treatment(P＜0.05). The levels of cTnI, CK, LDH and NT-proBNP in the two groups after treatment were significantly lower than those before treatment(P < 0.05),especially in the observation group(P＜0.05). The incidence rate of the adverse reactions in the observation group was significantly lower than that in the control group (P＜0.05). Conclusions rhBNP can significantly improve the therapeutic effect in the elderly patients with acute left heart failure, improving the cardiac function, reducing the cardiac load, improving the level of myocardial injury markers, with less side effects.

Key words: recombinant human brain natriuretic peptide, aged, acute left heart failure, myocardial injury

中图分类号:

R541.6

丁超, 储岳峰, 冯俊. 重组人脑利钠肽治疗老年急性左心衰病人的效果及对心肌损伤标志物水平的影响[J]. 实用老年医学, 2022, 36(10): 1042-1045.

DING Chao, CHU Yue-feng, FENG Jun. Effect of recombinant human brain natriuretic peptide on myocardial injury markers in elderly patients with acute left heart failure[J]. Practical Geriatrics, 2022, 36(10): 1042-1045.

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