摘要
目的 研究重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)联合静脉血液超滤对老年慢性心力衰竭急性失代偿期患者N-末端脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)、葡萄糖调节蛋白(glucose-regulatory protein,GRP)78、正五聚蛋白(pentraxin,PTX)3及生长分化因子(growth differentiation factor,GDF)-15的影响。方法 纳入我院2021年1月至2023年11月收治的130例老年慢性心力衰竭急性失代偿期患者,采用随机数字表法将患者随机分为试验组及对照组,每组65例。试验组采用常规疗法+静脉血液超滤+rhBNP,对照组采用常规疗法+静脉血液超滤。统计分析两组临床疗效、心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)及血清NT-proBNP水平]、GRP78、PTX3、GDF-15水平及不良反应发生率。结果 试验组临床总有效率高于对照组(96.92% vs 81.54%,χ~2=4.029,P=0.046)。治疗后,两组LVEF均较治疗前升高(P<0.01),且试验组高于对照组(P<0.01),LVEDD、LVESD及血清NT-proBNP水平均较治疗前降低(P<0.01),且试验组低于于对照组(P<0.01);两组治疗后血清GRP78、PTX3及GDF-15水平均较治疗前下降(P <0.05或P <0.01),且试验组低于于对照组(P <0.05或P <0.01)。两组不良反应发生率比较,差异无统计学意义(26.15%vs 16.92%,χ~2=0.369,P=0.642)。结论rhBNP联合血液超滤能够减轻老年慢性心力衰竭急性失代偿期患者心肌炎症损害及应激损伤,增强心脏泵血能力,降低心脏容量负荷,整体改善心功能。
Objective To investigate the effects of recombinant human brain natriuretic peptide(rhBNP)combined with intravenous blood ultrafiltration on N-terminal pro brain natriuretic peptide(NT-proBNP),glucose-regulatory protein(GRP)78,pentraxin(PTX)3 and growth differentiation factor(GDF)-15 in elderly patients with acute decompensation of chronic heart failure.Methods A total of 130 elderly patients with acute decompensation of chronic heart failure in our hospital from January 2021 to November 2023 were selected and randomly divided into experimental group and control group according to random number table,with 65 cases in each group.The experimental group received conventional therapy+venous blood ultrafiltration+rhBNP,and the control group received conventional therapy+venous blood ultraffltration.The clinical efffcacy,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and serum level of NTproBNP],the serum levels of GRP78,PTX3,GDF-15 and the incidence of adverse reactions were statistically analyzed in the two groups.Results The total effective rate of experimental group was higher than that of control group(96.92%vs 81.54%,χ2=4.029,P=0.046).After treatment,LVEF in both groups was higher than before treatment(P<0.01),and the experimental group was higher than the control group(P<0.01),while LVEDD,LVESD and the serum level of NTproBNP were lower than before treatment(P<0.01),and the experimental group was lower than the control group(P<0.01).After treatment,the serum levels of GRP78,PTX3 and GDF-15 in both groups were decreased compared with before treatment(P<0.05 or P<0.01),and the experimental group was lower than the control group(P<0.05 or P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(26.15%vs 16.92%,χ2=0.369,P=0.642).Conclusion rhBNP combined with blood ultrafiltration can alleviate the inflammatory damage and stress damage of myocardium in elderly patients with acute decompensation of chronic heart failure,enhance the pumping capacity of the heart,reduce the volume load of the heart,and improve the overall cardiac function.
作者
纪静
张蕾
JI Jing;ZHANG Lei(Department of Cardiology,Beijing Yangfangdian Hospital,Beijing 100038,China;Department of Rehabilitation,Beijing Yangfangdian Hospital,Beijing 100038,China)
出处
《世界临床药物》
CAS
2024年第8期869-875,890,共8页
World Clinical Drug
关键词
慢性心力衰竭
急性失代偿期
重组人脑利钠肽
血液超滤
N-末端脑钠肽前体
chronic heart failure
acute decompensation
recombinant human brain natriuretic peptide
blood ultraffltration
N-terminal pro-brain natriuretic peptide
