摘要
目的研究应用冻干重组人脑利钠肽(rhBNP)在冠状动脉搭桥术围手术期中的应用效果。方法回顾性分析接受冠状动脉搭桥手术并应用rhBNP治疗的80例患者病历资料。根据是否使用体外循环,分为体外循环组(n=45)和非体外循环组(n=35)。两组患者术后同时予以常规冠心病一级预防药物和冻干重组人脑利钠肽进行治疗。治疗后,比较分析两组疗效状况,并分析治疗前后C反应蛋白(CRP)和B型利钠肽(BNP)及左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)等的差异,并随访调查两组患者不良反应发生状况。结果体外循环组与非体外循环组治疗总有效率差异无统计学意义(91. 11%比91. 43%,P> 0. 05)。治疗前,两组患者的CRP及BNP水平和相对表达量差异无统计学意义(P> 0. 05);治疗后,两组患者的CRP及BNP水平和相对表达量均显著降低,且非体外循环组CRP及BNP水平和相对表达量明显低于体外循环组,两组差异有统计学意义(P <0. 05)。治疗前,两组患者的LVEF、LVEDD及LVESD差异无统计学意义(P> 0. 05);治疗后,两组患者的LVEDD及LVESD均明显降低,且非体外循环组LVEDD及LVESD水平明显低于体外循环组,两组差异有统计学意义(P <0. 05)。两组患者的不良反应发生率无显著性差异(6. 67%比11. 43%,P> 0. 05)。结论冻干重组人脑利钠肽治疗体外循环下冠脉搭桥和非体外循环下冠脉搭桥所致心力衰竭均有效果,且对非体外循环组冠脉搭桥所致心力衰竭患者的CRP及BNP及心室结构改善效果较体外循环冠脉搭桥心脏病患者更好。
Objective To study the effect of rhBNP application during perioperative period of coronary- bypass graft. Methods Eighty- patients with coronary- bypass graft were retrospectively analyzed in this study. They were divided into on-pmnp CABG group（ u =45） and off-pump CABG group（ u = 35 ） according to the different operation. The pa- tients of two groups were treated with coronary- prevention drugs, and combined with rhBNP. The curative effect of two groups were analyzed and compared after treatment,and the C reaction protein , B type natriuretic peptide （BNP） , left ventricular ejection fraction,left ventricular parameters （ LVEF）, left ventricular end diastolic diameter （LVEDD） and left ventricular end systolic diameter （LVESD） were compared before and after treatment. After treatment, the incidence of adverse reactions of the two groups was followed up. Results There was no significant difference in the total effective rate between the two groups （91.11% vs 91.43 %, P 〉 0.05 ）. There was no significant difference between the C RP and BNP levels and the relative quantitative expression in two groups before treatment （ P 〉 0.05 ） ; CRP and BNP and the relative quantitative expression of the two groups were significantly decreased after treatment, and the CRP and BNP of off-pump CABG group were significantly- lower than those of the on-pump CABG group, the difference was statistically significant （ P 〈 0.05 ）. The LVEF, LVEDD and LVESD had no significant difference between the two groups before treatment（P 〉 0.05） ; but the LVEDD and LVESD of the two groups were significantly decreased after treatment, and LVEDD and LVESD of off-pump CABG group were significantly lower than those of the on-pump CABG group, the difference was statistically significant（ P 〈 0.05 ）. There was no significant difference in the incidence of adverse reac- tions between the two groups （6.67% vs 11.43% ,P 〉 0.05）. Conclusion The rhBNP had positive effect on on-pump CABG and off-pum
作者
孙海磊
严中亚
葛建军
赵智伟
樊扬名
蒋辉
Sun Hailei;Yan Zhongya;Ge Jianjun;Zhao Zhiwei;Fan Yangming;Jiang Hui(Department of Cardiac Surgery,the First Affiliated Hospital of USTC,Division of Limb Sciences and Medicine,University of Science and Technology of China,Hejbi 230001,China)
出处
《中国临床保健杂志》
CAS
2018年第5期661-664,共4页
Chinese Journal of Clinical Healthcare
基金
安徽省科技攻关课题(13010142198)
关键词
冠状动脉旁路移植术
脑利钠肽
心力衰竭
体外循环
Coronary artery bypass
Natriuretic peptide
brain
Heart failure
Extracorporeal circulation
