摘要
目的探讨重组人脑利钠肽与左西孟旦联合治疗急性心力衰竭的疗效及对患者心功能恢复、生活质量的影响。方法运用随机盲选法,选取2023年2月至2023年7月郑州市第七人民医院心血管内科接诊的60例急性心力衰竭患者为对照组;2023年8月至2024年2月接诊的60例急性心力衰竭患者为研究组。对照组男29例,女31例,年龄(67.91±2.63)岁,发病至就诊时间(4.48±0.47)h,美国纽约心脏病协会(NYHA)心功能分级:Ⅱ级14例、Ⅲ级40例、Ⅳ级6例。研究组男22例,女38例,年龄(67.12±2.84)岁,发病至就诊时间(4.91±0.42)h,NYHA心功能分级:Ⅱ级15例、Ⅲ级36例、Ⅳ级9例。对照组在常规对症治疗基础上接受左西孟旦注射液治疗,静脉滴注,初始负荷剂量12μg/kg,用药10 min后,按照0.1μg(/kg·min)持续输注。研究组在对照组治疗基础上加用重组人脑利钠肽治疗,静脉滴注,初始负荷剂量1.5μg/kg,用药2 min后,按照0.01μg(/kg·min)持续输注。两组患者均于早餐后30 min给药,每日1次。72 h后评估疗效。两组患者出院后持续予以吸氧、利尿、扩张血管等维持治疗2个月。对比两组临床疗效、心功能[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心率(HR)、心脏指数(CI)]、血清学指标[乳酸(LA)、肌钙蛋白(CTnT)、N末端B型利钠肽前体(NT-ProBNP)]、生活质量[中国心血管病人生活质量评定问卷(CQQC)]及不良反应发生情况。采用χ^(2)检验、t检验。结果研究组治疗总有效率高于对照组[95.00%(57/60)比83.33%(50/60)],差异有统计学意义(χ^(2)=4.227,P=0.040)。治疗72 h、2个月后,研究组患者的LVEDD、LVEF、HR、CI分别为(54.26±3.82)mm、(53.15±3.24)mm、(53.23±3.57)%、(55.28±3.69)%、(72.31±6.04)次/min、(71.19±5.86)次/min、(3.82±0.34)L(/min·m^(2))、(3.94±0.41)L(/min·m^(2)),对照组分别为(56.11±4.06)mm、(55.17±4.12)mm、(48.75±3.29)%、(51.34±3.37)%、(79.62±7.18)次/min、(76.22±6.34)次/min、(
Objective To explore the efficacy of the combination of recombinant human brain natriuretic peptide and levosimendan on acute heart failure and the effects on patients'cardiac function recovery and quality of life.Methods A total of 60 patients with acute heart failure admitted to the Department of Cardiovascular Medicine,Zhengzhou Seventh People's Hospital from February 2023 to July 2023 were selected as the control group by random blind selection method;60 patients with acute heart failure admitted from August 2023 to February 2024 were selected as the study group.In the control group,there were 29 males and 31 females,aged(67.91±2.63)years,the time from onset to treatment was(4.48±0.47)h,and the cardiac functional classification of New York Heart Association(NYHA)was as follows:gradeⅡin 14 cases,gradeⅢin 40 cases,and gradeⅣin 6 cases.In the study group,there were 22 males and 38 females,aged(67.12±2.84)years,the time from onset to treatment was(4.91±0.42)h,and the NYHA cardiac functional classification was gradeⅡin 15 cases,gradeⅢin 36 cases,and gradeⅣin 9 cases.On the basis of conventional symptomatic treatment,the control group received levosimendan injection with an initial load dose of 12μg/kg and continued infusion at 0.1μg/(kg·min)after 10 min of administration.On the basis of the control group,the study group was treated with recombinant human brain natriuretic peptide by intravenous infusion at an initial load dose of 1.5μg/kg and continued infusion at 0.01μg/(kg·min)after 2 min of administration.Both groups were administered 30 min after breakfast,once a day.The therapeutic effect was evaluated after 72 h.After discharge,the patients in both groups continued to receive maintenance treatment such as oxygen inhalation,diuresis,and vasodilation for 2 months.The clinical efficacy,cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),heart rate(HR),and cardiac index(CI)],serological indexes[lactic acid(LA),troponin(CTnT),N-terminal B-
作者
杨冠旭
赵育洁
李连东
杨小溪
杨毅博
陈金福
Yang Guanxu;Zhao Yujie;Li Liandong;Yang Xiaoxi;Yang Yibo;Chen Jinfu(Department of Cardiovascular Medicine,Zhengzhou Seventh People's Hospital,Henan Province Key Laboratory of Cardiac Arrhythmia,Zhengzhou 450000,China)
出处
《国际医药卫生导报》
2024年第22期3801-3806,共6页
International Medicine and Health Guidance News
基金
河南省科技攻关项目(222102310667)
郑州市科技惠民项目(2022KJHM0033)。
关键词
急性心力衰竭
左西孟旦
重组人脑利钠肽
心功能
生活质量
Acute heart failure
Levosimendan
Recombinant human brain natriuretic peptide
Heart function
Quality of life
