左西孟旦、重组人脑利钠肽联合米力农治疗顽固性心力衰竭患者对其血清ET-1、ALD水平的影响

目的探讨左西孟旦、重组人脑利钠肽联合米力农治疗顽固性心力衰竭(RHF)患者对其血清内皮素-1(ET-1)、醛固酮(ALD)水平的影响。方法选取2018年8月至2020年8月于本院进行治疗的80例RHF患者作为研究对象,采用简单随机分组法分为A组和B组,各40例。A组采用左西孟旦(LEV)联合米力农治疗,B组采用重组人脑利钠肽(rh-BNP)联合米力农治疗,比较两组临床疗效、不良反应发生情况、ET-1、ALD、左心室射血分数(LVEF)、N末端B型利尿钠肽原(NT-proBNP)水平以及6 min步行试验距离(6MWT)。结果 A组治疗总有效率为97.50%,高于B组的85.00%(P<0.05)。治疗7 d后,两组LVEF和6MWT距离均大于治疗前(P<0.05),NT-proBNP水平均低于治疗前,且A组LVEF和6MWT距离大于B组,NT-proBNP水平低于B组(P<0.05)。治疗7 d后,两组ET-1、ALD水平均低于治疗前,且A组低于B组(P<0.05)。A组不良反应发生率为12.50%,低于B组的32.50%(P<0.05)。结论 LEV、rh-BNP联合米力农治疗RHF患者均可取得显著疗效,但LEV联合米力农改善患者心功能、降低ET-1和ALD水平的效果更显著,且不良反应较少。

Effect of levosimendan,recombinant human brain natriuretic peptide combined with milrinone on serum ET-1 and ALD levels in patients with intractable heart failure

Objective To investigate the effect of levosimendan, recombinant human brain natriuretic peptide combined with milrinone on the serum endothelin-1(ET-1) and aldosterone(ALD) levels in patients with refractory heart failure(RHF). Methods 80 patients with RHF who were treated in our hospital from August 2018 to August 2020 were selected as the research subjects, and they were divided into group A and group B according to simple randomization method, with 40 cases in each group. Group A was treated with levosimendan(LEV) combined with milrinone, and group B was treated with recombinant human brain natriuretic peptide(rh-BNP) combined with milrinone. The clinical efficacy, adverse reactions,ET-1, ALD, left ventricular ejection fraction(LVEF), N-terminal B-type natriuretic peptide(NT-proBNP) and 6 MWT were compared between the two groups. Results The total effective rate of treatment in group A was 97.50%, which was higher than 85.00% in group B(P<0.05). After 7 d of treatment, the distance between LVEF and 6 MWT in the two groups was bigger than before treatment(P<0.05), the level of NT-proBNP was lower than before treatment, and the distance between LVEF and 6 MWT in group A was bigger than that in group B, and the level of NT-proBNP was lower than that in group B(P<0.05). After 7 d of treatment, the levels of ET-1 and ALD in the two groups were lower than before treatment, and the levels of group A were lower than those of group B(P<0.05). The total incidence of adverse reactions in group A was 12.50%, which was lower than32.50% in group B(P<0.05). Conclusion LEV, rh-BNP combined with milrinone can achieve significant effects in the treatment of RHF patients,but LEV combined with milrinone can improve the cardiac function of patients and reduce the levels of ET-1 and ALD more significantly, and has fewer adverse reactions.