重组人脑利钠肽治疗老年慢性心衰患者急性加重期的临床研究

摘要

目的 观察重组人脑利钠肽治疗老年慢性心力衰竭(心衰)患者急性加重期的疗效.方法 收集2012年4月～2015年10月就诊于四川省宜宾市第二人民医院心内科老年慢性心衰急性加重期患者70例,随机分为实验组和对照组,每组35例.实验组采用重组人脑利钠肽治疗,对照组使用硝普钠治疗,比较两组治疗效果,记录不良反应以及治疗前后左室舒张末期内径(LVEDD)、射血分数(EF)、心输出量(CO)、脑钠肽(BNP)水平变化.结果 实验组有效率88.6％,对照组有效率65.7％,实验组疗效优于对照组,差异有统计学意义(P<0.05);实验组不良反应率为14.3％,对照组不良反应率为42.9％,实验组用药后不良反应情况优于对照组,差异有统计学意义(P<0.05);治疗前,两组LVEDD、EF、CO、血浆BNP水平差异无统计学意义(P>0.05),治疗后实验组LVEDD、EF、CO、血浆BNP水平改善情况优于对照组,差异具有统计学意义(P<0.05).结论 重组人脑利钠肽治疗老年慢性心衰患者急性加重期具有良好的效果,治疗后副作用小,且LVEDD、EF、CO、血浆BNP水平均有良好改善,值得临床推广使用.%Objective To observe the therapeutic effect of recombinant human brain natriuretic peptide in elderly patients with acute exacerbation of chronic heart failure. Methods 70 elderly patients with acute exacerbation of chronic heart failure admitted from April 2012 to October 2015 were randomly divided into experimental group and control group, with 35 patients in each group. The experimental group were treated with recombinant human brain natriuretic peptide, the control group received sodium nitroprusside treatment. Treatment effect in two groups was compared, and adverse reactions were recorded. Left ventricular end diastolic diameter (LVEDd), ejection fraction (EF), cardiac output (CO), plasma brain natriuretic peptide (BNP) level changes were recorded.Results In the experimental group, the efficiency is 88.6％, while in the control group, the effective rate was 65.7％. The effect of experimental group was better than that of the control group, the difference is statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was 14.3％. In the control group, the incidence of adverse reactions was 42.9％. The incidence of adverse reactions in the experimental group was lower than that in the control group (P<0.05). Before treatment, there was no significant difference with respect to LVEDd, EF, Co, and plasma BNP level (P>0.05). After treatment, improvement of LVEDd, EF, CO and plasma BNP level of experimental group is better than those of the control group (P<0.05).Conclusion Recombinant human brain natriuretic peptide in the treatment of elderly patients with chronic heart failure acute exacerbation has good effect with less side effect, and LVEDd, EF, CO, plasma BNP levels were well improved. It is worth for clinical application.