摘要
目的观察重组人脑利钠肽联合参附注射液对急性心肌梗死合并泵衰竭患者心功能及神经内分泌激素水平的影响。方法急性心肌梗死合并泵衰竭患者70例随机分为对照组和治疗组,每组35例。对照组采用常规治疗,治疗组在常规治疗的基础上加用重组人脑利钠肽和参附注射液。2组均治疗7 d,观察2组治疗前后左心室收缩末期容量(LESV)、左心室舒张末期容量(LEDV)及左心室射血分数(LVEF)、N-末端脑钠肽前体(NT-pro-BNP)、肾素(R)、内皮素(ET)、去甲肾上腺素(NE)、超敏C-反应蛋白(hs-CRP)、血K^+、血Na^+、心率(HR)及Killip分级情况,并比较2组不良心血管事件发生率。结果 2组治疗前后血K^+、血Na^+比较差异无统计学意义(P>0.05)。2组治疗后HR均有下降,与治疗前比较差异均有统计学意义(P<0.05),且治疗组下降优于对照组(P<0.05)。2组治疗后Killip分级有不同程度的下降(P<0.05),治疗组较对照组下降更显著(P<0.05)。2组治疗前NT-proBNP、NE、R、ET及hs-CRP水平比较差异均无统计学意义(P>0.05),2组治疗后NT-proBNPNE、R、ET及hs-CRP水平较治疗前显著降低(P<0.05),且治疗组治疗后NT-proBNPNE、R、ET及hs-CRP水平均明显低于对照组(P均<0.05)。治疗组不良心血管事件发生率低于对照组(P<0.05)。结论重组人脑利钠肽联合参附注射液治疗急性心肌梗死合并泵衰竭疗效确切,并能改善患者心功能及神经内分泌激素水平,降低不良心血管事件发生。
Objective To observe the effects of recombinant human brain natriuretic peptide combined with Shenfu injection on cardiac function and neuroendocrine hormone levels of patients with acute myocardial infarction complicated by pump failure. Methods Seventy patients with acute myocardial infarction combined by pump failure were randomly divided into control group and observation group,with 35 aptients in each group. The patients in control group were treated by conventional treatment,however,the patients in observation group,on the basis of control group,were treated by recombinant human brain natriuretic peptide combined with Shenfu injection. The left ventricular end-systolic volume（ LESV）,left ventricular end-diastolic volume（ LEDV） and left ventricular ejection fraction（ LVEF） were detected before and after treatment. Moreover the levels of NT-pro-BNP, renin（ R）, endothelin（ ET）, norepinephrine（ ET）, hypersensitive C-reactive protein（ hs-CRP）,blood K~＋,blood Na~＋,heart rate（ HR）,Killip grading and incidence rates of adverse cardiovascular events were observed and compared between two groups. Results There were no significant differences in the levels of blood K~＋and blood Na~＋before and after treatment between two groups（ P 〉0. 05）,however,the HR was decreased after treatment in both groups,as compared with that before treatment（ P 〈0. 05）,moreover,the decrease degree in observation group was more obvious that that in control group（ P〈 0. 05）. After treatment Killip grade was decreased in both groups,and the decrease degree in observation group was more obvious that that in control group（ P〈 0. 05）. There were no significant differences in the levels of NT-proBNP,NE,R,ET and hs-CRP between two groups（ P〉 0. 05）,however,which were significantly decreased after treatment in both groups,as compared with those before treatment（ P 〈0. 05）,moreover,the levels of NT-proBNPNE,R,ET and hs-CRP in observation group were significantly lower than those in control group（ P〈 0. 05）. Besides the incidence rate of adverse cardiovascular events in observation group was 17. 1% ,which was significantly lower than that in control group（ P〈 0. 0 5）.Conclusion Recombinant human brain natriuretic peptide combined with Shenfu injection in treatment of acute myocardial infarction complicated by pump failure is effective,which can improve patient＇s cardiac function and neuroendocrine hormone levels and can decrease the incidence rate of adverse cardiovascular events.
出处
《河北医药》
CAS
2018年第1期19-22,共4页
Hebei Medical Journal
基金
国家重点基础研究发展计划项目(973计划,编号:2012CB518600)
关键词
重组人脑利钠肽
参附注射液
急性心肌梗死合并泵衰竭
recombinant human brain natriuretic peptide
Shenfu injection
acute myocardial infarction with pump failure
