短期rhBNP联合小剂量多巴酚丁胺治疗急性心肌梗死直接PCI术后泵衰竭的疗效观察

摘要

Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide combined with low dose dobutamine for the treatment of pump failure following PCI for acute myocardial infarction. Methods Eighty - three consecutive patients with pump failure following PCI for acute myocardial infarction were divided into rhBNP group ( control group ) and rhBNP combined with low dose dobutamine group ( treatment group ). Single rhBNP and rhBNP combined with low dose dobutamine treatments were given to patients in control group and treatment group for 72 h,respectively. The plasma BNP, invasive artery blood pressure, heart rate, left ventricular ejection fraction, left ventricular diastolic diameter, left atrial diameter, pulmonary artery pressure, serum creatinine and serum sodium were recorded before and after treatment. Results After the treatment, significantly more prominent improvement in invasive artery blood pressure, left ventricular ejection fraction, left ventricular diastolic diameter and left atrial diameter was found in the treatment group, comparing with those in the control group ( P ＜ 0.01 ). No significant difference was found in the plasma BNP, pulmonary artery pressure, heart rate and serum sodium. Conclusion rhBNP combined with low dose dobutamine was safe and effective for the treatment of pump failure following PCI for acute myocardial infarction.%目的 观察短期国产重组人脑利钠肽(rhBNP)联合小剂量多巴酚丁胺治疗急性心肌梗死致泵衰竭的疗效及安全性.方法 将住院诊断为急性心肌梗死直接经皮冠状动脉介入术后泵衰竭患者83例分为两组.对照组在常规治疗基础上单用rhBNP,观察组在同一基础上用国产rhBNP联合小剂量多巴酚丁胺,两组均连用72 h,测定两组治疗前和停止用药8 h后血浆脑利钠肽(BNP)、有创动脉压、心率、左室射血分数、左室舒张内径、左房内径、肺动脉压、血肌酐、血钠等指标,比较两组治疗前后上述指标的变化.结果 观察组治疗后与对照组患者在有创动脉压、左室射血分数、左室舒张内径、左房内径方面比较,差异均有显著性(P<0.01);肺动脉压、血浆BNP、血钾、血钠和心率差异无显著性(P>0.01);无增加心血管不良事件发生率,且住院时间减少,医疗费用降低.结论 急性心肌梗死致泵衰竭短期使用rhBNP联合小剂量多巴酚丁胺治疗是有效、安全和经济的.