【摘要】 目的:研究重组人脑利钠肽(rhBNP)治疗对老年急性失代偿期心力衰竭(ADHF)患者心肌酶及N末端B型利钠肽原(NT-proBNP)的影响。方法:选取2017年6月至2018年6月我院收治的150例老年ADHF患者列为研究对象,按简单随机数字表法以1:1比例分为对照组和研究组,各75例,对照组患者使用常规方法进行治疗,研究组则在常规治疗上使用rhBNP进行治疗。比较两组疗效,治疗前后患者的心功能指标、24h尿量、心肌酶水平、NT-proBNP水平,并监测不良反应的发生情况。结果:治疗后,研究组总有效率高于对照组(P<0.05);治疗后,两组患者左心室射血分数(LVEF)高于治疗前而左室收缩末期容积(LVESV)和左室舒张末末期容积(LVEDV)低于治疗前,且研究组LVEF高于对照组、LVESV和LVEDV低于对照组(P<0.05);治疗后,两组患者24h尿量高于治疗前,且研究组患者24h尿量高于对照组(P <0.05);治疗后,两组患者的乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、α-羟丁酸脱氢酶(α-HBD)水平均低于治疗前,且研究组上述指标均低于对照组,(P<0.05);治疗后,两组患者NT-proBNP水平低于治疗前,且研究组患者NT-proBNP水平低于对照组(P <0.05);治疗期间,两组患者的不良反应发生率分别为18.67%和21.33%,两组对比差异无统计学意义(P>0.05)。结论:应用rhBNP治疗急性失代偿期心力衰竭老年患者,疗效显著,改善患者体内的心肌酶水平,增加排尿量,提升患者的心功能,安全性高,有较好的应用价值。更多还原

【Abstract】 Objective: To study the effects of recombinant human brain natriuretic peptide( rhBNP) on myocardial enzymes and N-terminal pro-brain natriuretic peptide( NT-proBNP) in elderly patients with acute decompensated heart failure( ADHF). Methods: A total of 150 elderly ADHF patients admitted to our hospital from June 2017 to June 2018 were enrolled in the study. They were divided into control group and study group by simple random number table method,with 75 cases in each group. Control group was treated with conventional methods while study group was treated with rhBNP on the basis of conventional treatment,and they were treated for 1 week. The efficacy,and cardiac function indexes,24 h urine volume,myocardial enzymes,and NT-proBNP before and after treatment were compared between the two groups,and the occurrence of adverse reactions was monitored. Results: The total post-treatment effective rate in study group was higher than that in control group( P < 0.05). The post-treatment evaluation reveals the following facts,compared to pre-treatment: the left ventricular ejection fraction( LVEF) in both groups was higher while the left ventricular end-systolic volume( LVESV) and left ventricular end-diastolic volume( LVEDV) were lower,and the LVEF in study group was higher than that in control group while the LVESV and LVEDV were lower than those in control group( P <0.05). The 24 h urine volume in both groups was higher and the 24 h urine volume in study group was higher than that in control group( P < 0. 05). The levels of lactate dehydrogenase( LDH),creatine kinase( CK),creatine kinase isoenzyme MB( CK-MB) and α-hydroxybutyrate dehydrogenase( α-HBD) in both groups were lower and the above indexes in study group were lower than those in control group( P <0.05). The level of NT-proBNP in both groups was lower and the level of NT-proBNP in study group was lower than that in control group( P <0.05). The incidence rates of adverse reactions in both groups during treatment were 18.67% and 21.33% respectively( P >0.05). Conclusion: RhBNP has significant efficacy in the treatment of elderly patients with acute decompensated heart failure. It helps improve the level of myocardial enzymes,increase urine output and improve cardiac function,and it proves to be highly safe and applicable.更多还原