【摘要】 目的 探究左西孟旦联合重组人脑钠肽（rhBNP）治疗急性心力衰竭（急性心衰，AHF疗效及对N末端脑钠肽前体（NT-proBNP）的影响。方法 选取2019年2月至2022年2月于北京普仁医院收治的126例急性心衰患者为研究对象，按照随机数字表法分为对照组和观察组，每组各63例，对照组采用左西孟旦治疗，观察组采用左西孟旦联合rhBNP治疗，比较两组疗效、心功能指标、血流动力学、血清乳酸（LA）、NT-proBNP水平及远期预后。结果 治疗72 h后，观察组治疗总有效率、心排量指数（CI）、左室射血分数（LVEF）、LA、NT-proBNP水平，中心静脉压（CVP）、平均动脉压（MAP）均高于对照组；左心室舒张末期内径（LVEDD）、左室舒张末期压力（LVEDP）、血清LA、NT-proBNP水平及出院3个月内因心衰再入院率均低于对照组，差异有统计学意义（P<0.05）；两组出院6个月内全因死亡率对比，差异无统计学意义（P>0.05）。结论 左西孟旦联合rhBNP可显著提高治疗急性心衰的临床疗效，稳定血流动力学，缓解患者心衰症状，改善心功能及远期预后。更多还原

【Abstract】 Objective To discuss the curative effect and influence of levosimendan combined with recombinant human brain natriuretic peptide(rhBNP) on acute heart failure(AHF) and N-terminal pro-brain natriuretic peptide(NT-proBNP). Methods AHF patients(n=126) were chosen from Beijing Puren Hospital from Feb. 2019 to Feb. 2022, and they were divided, according to random digital table, into control group and observation group(each n=63). The control group was treated with levosimendan, and observation group was treated with levosimendan combined with rhBNP. The curative effect, indexes of heart function, hemodynamics, levels of serum lactic acid(LA) and N-terminal pro-brain natriuretic peptide(NT-proBNP) and long-term prognosis were compared between 2 groups. Results After treatment for 72 h, the total effective rate, cardiac output index(CI), left ventricular ejection fraction(LVEF), LA, NT-proBNP, central venous pressure(CVP) and mean arterial pressure(MAP) were all higher in observation group than those in control group, and left ventricular end-diastolic inner diameter(LVEDD), left ventricular end-diastolic pressure(LVEDP), levels of serum LA and NT-proBNP,and rehospitalization rate due to heart failure within 3 months after discharged were all lower in observation group than those in control group(P<0.05). The difference in all-cause mortality had no statistical significance between 2 groups within 6 months after discharged(P>0.05). Conclusion Levosimendan combined with rhBNP can significantly improve clinical efficacy in AHF treatment, stabilize hemodynamics, effectively alleviate the symptoms of heart failure, and improve heart function and long-term prognosis in AHF patients.更多还原