摘要
目的分析急性心肌梗死后心力衰竭患者应用重组人脑利钠肽(新活素)治疗后的临床疗效及安全性.方法收集分析笔者医院2017年7月~ 2018年8月收治的急性心肌梗死后心力衰竭患者70例,随机分为新活素治疗组(36例)和硝酸甘油治疗组(34例),其中硝酸甘油组具体方法:10 ~ 100μg/(kg·min),根据患者体重调整用量后,持续72h.新活素组具体方法:0.15μg/kg负荷量,根据患者体重调整用量后,给予患者静脉注射,10min内完成;之后0.0075~0.0200μg/(kg·min)给予患者进行静脉滴注,持续72h.在用药治疗前后监测患者心率和NT-proBNP水平,在用药24、48、72h动态监测患者肾功能,包括肌酐(Scr)、尿素(Urea)、胱抑素C(Cyc)及监测患者血压水平变化.结果两组基线资料比较差异无统计学意义(P>0.05).硝酸甘油组和新活素组患者治疗后NT-proBNP与治疗前基线水平比较,差异有统计学意义(P<0.05),新活素组患者治疗心力衰竭的临床效果与硝酸甘油组比较,差异有统计学意义(P<0.05).用药早期(24h),新活素组肌酐水平与硝酸甘油组和新活素组基线水平比较,差异有统计学意义(P<0.05).同时用药早期新活素组血压水平与硝酸甘油组和新活素组基线水平比较,差异有统计学意义(P<0.05).而在用药48h和72h后,肾功能(包括肌酐、尿素、胱抑素C)与血压水平在新活素组与硝酸甘油组以及新活素基线水平比较,差异无统计学意义.结论新活素可显著改善急性心肌梗死患者心力衰竭的临床表现,用药早期(24h)可见肌酐水平升高及血压下降,但疗程结束对患者肾脏功能(包括肌酐、尿素、胱抑素C)及血压水平无明显影响,其有效性和安全性值得在急性心肌梗死后心力衰竭患者群中推广.
Objective To investigate the clinical effectiveness and safety of recombinant human brain natriuretic peptide ( rhBNP, Xin Huo Su) in patients with acute heart failure( AHF) following acute myocardial infarction( AMI). Methods Totaly 70 patients with AHF following AMI during July 2017 to July 2018 were enrolled in this clinical trial. Eligible patients were randomly assigned to Xin Huo Su ( n = 36) or nitroglycerin( n = 34 ) group. Patients in the Xin Huo Su group received rhBNP 0. 15μg /kg bolus injection after randomization followed by an adjusted - dose[0. 0075 - 0. 0200μg/( kg·min)] for 72 hours, while patients in nitroglycerin group received infusion of nitroglycerin with an adjusted - dose[ 10 - 100jxg/( kg ·min)] for 72 hours. Standard clinical and laboratory data were collected. The vital signs including blood pressure, heart rate were monitored and the NT - proBNP level was tested before and after the above treatment. The levels of renal function including serum creatinine ( SCr), Urea and cystatin C ( Cyc) and blood pressure were measured at baseline and repeated at the end of the 24 , 48 and 72 hours after infusion. Results Of the 70 patients enrolled, there were no significant differences in baseline characteristics between the two groups( all P > 0. 05 ). Compared with baseline level before treatment, both group showed lower NT-proBNP levels( P < 0. 05 ). Compared with nitroglycerin group, the clinical effectiveness of Xin Huo Su on heart failure was better( P < 0. 05 ). The concentrations of SCr was higher in Xin Huo Su group than those in nitroglycerin group at 24h after treatments and with the baseline of Xin Huo Su group( all P < 0. 05 ). In Xin Huo Su group, levels of SBP and DBP decreased significantly than those in nitroglycerin group at 24h and with the baseline of Xin Huo Su group( all P <0. 05 ). Levels of SCr, Urea, Cyc, SBP and DBP in Xin Huo Su group have no significantly changes at 48h and 72h compared with nitroglycerin group. Conclusion Xin Huo Su could modify the clinical symptom
作者
张凤云
徐晤
王向东
葛力萁
段洋
王志荣
Zhang Fengyun;Xu Wu;Wang Xiangdong(Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University Jiangsu 221000, China)
出处
《医学研究杂志》
2019年第6期50-54,共5页
Journal of Medical Research
基金
国家自然科学基金青年基金资助项目(81700231)
关键词
急性心力衰竭
急性心肌梗死
新活素
临床效果
安全性
Acute heart failure
Acute myocardiol infarction
Xin Huo Su
Clinical effectiveness
Safety
