参附注射液联合重组人脑利钠肽治疗急性左心衰竭疗效观察

摘要

目的:探讨参附注射液联合重组人脑利钠肽(rhBNP)治疗急性左心衰竭患者的临床疗效.方法:选择在我院接受治疗的急性左心衰竭患者92例,被分为 rhBNP组(46例,给予 rhBNP治疗),联合治疗组(46例,给予参附注射液联合rhBNP治疗),均治疗两周.记录两组患者治疗前后心功能、肾功能、血气分析等指标,对比两组患者治疗后的临床效果.结果:治疗后,患者心功能、肾功能、血气指标均较治疗前明显改善(P均<0.01);与rhBNP组比较,联合治疗组左室射血分数[(51.21 ± 4.23)% 比(56.02 ± 5.02)%]、左室短轴缩短率[(28.02 ± 4.78)% 比(32.78 ± 4.02)%]、动脉血氧分压[(62.45 ± 6.02)mmHg比(75.56 ± 5.78)mmHg]均明显提高,左室舒张末期内径[(49.56 ± 5.02)mm比(45.12 ± 6.02)mm]明显减小,二氧化碳分压[(41.78 ± 5.89)mm-Hg比(35.78 ± 6.02)mmHg]、血肌酐[(92.02 ± 5.78)μmol/L比(86.45 ± 8.12)μmol/L]和尿素氮[(5.99 ± 1.12)mmol/L比(4.56 ± 1.02)mmol/L]水平均明显降低(P均<0.01);治疗后,联合治疗组总有效率明显高于rhBNP组(95.56% 比76.08%,P=0.007).结论:参附注射液联合重组人脑利钠肽治疗,可明显改善急性左心衰患者的心功能、肾功能及血气指标,效果显著,值得临床推广使用.%Objective:To explore therapeutic effect of Shenfu injection combined recombinant human brain natriuret-ic peptide(rhBNP)on patients with acute left heart failure(ALHF).Methods:A total of 92 ALHF patients treated in our hospital were selected.They were divided into rhBNP group(n=46)and combined treatment group(n=46, received Shenfu injection combined rhBNP),both groups were treated for two weeks.Cardiac function,kidney function and blood gas analysis indexes before and after treatment,and therapeutic effect after treatment were re-corded and compared between two groups.Results:Compared with before treatment,there were significant im-provements in cardiac function,kidney function and blood gas indexes in both groups after treatment,P<0.01 all. Compared with rhBNP group,there were significant rise in left ventricular ejection fraction[(51.21 ± 4.23)% vs. (56.02 ± 5.02)%],left ventricular fractional shortening[(28.02 ± 4.78)% vs.(32.78 ± 4.02)%]and partial pres-sure of oxygen in artery[(62.45 ± 6.02)mmHg vs.(75.56 ± 5.78)mmHg],and significant reductions in left ven-tricular end-diastolic dimension[(49.56 ± 5.02)mm vs.(45.12 ± 6.02)mm],arterial partial pressure of carbon dioxide[(41.78 ± 5.89)mmHg vs.(35.78 ± 6.02)mmHg],serum creatinine[(92.02 ± 5.78)μmol/L vs.(86.45 ± 8.12)μmol/L]and blood urea nitrogen[(5.99 ± 1.12)mmol/L vs.(4.56 ± 1.02)mmol/L]in combined treat-ment group,P<0.01 all.After treatment,total effective rate of combined treatment group was significantly higher than that of rhBNP group(95.56% vs.76.08%,P<0.007).Conclusion:Shenfu injection combined rhBNP treat-ment can significantly improve cardiac function,kidney function and blood gas indexes with significant therapeutic effect in ALHF patients,which is worth extending.