重组人脑利钠肽联合艾司洛尔治疗缺血性心力衰竭的临床研究

目的探讨重组人脑利钠肽联合艾司洛尔治疗缺血性心力衰竭的安全性和有效性。方法选取平煤神马医疗集团总医院2015年10月—2016年10月收治的缺血性心力衰竭患者124例,随机分成对照组和治疗组,每组各62例。对照组患者静脉注射盐酸艾司洛尔注射液,首剂量为0.5 mg/kg,然后持续静脉泵入,速率为0.05 mg/(kg·min),根据患者血压、心率调整剂量,待临床症状缓解后停止给药。治疗组在对照组的基础上静脉注射冻干重组人脑利钠肽,首剂量为1.5μg/kg,然后持续静脉泵入,速率为7.5 ng/(kg·min),持续48 h。两组患者均连续治疗7 d。比较两组患者治疗前后临床疗效、超声心动图、心功能预后和不良反应发生情况。结果治疗后,对照组和治疗组总有效率分别为72.58%、91.94%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左心房舒张期内径(LADD)显著降低,左心室射血分数(LVEE)明显升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者上述指标改善情况显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者N末端心房利钠肽(NT-pro BNP)和内皮素-1(ET-1)均明显下降(P0.05);且治疗组NT-pro BNP和ET-1水平显著低于对照组(P0.05)。结论重组人脑利钠肽联合艾司洛尔治疗缺血性心力衰竭的临床疗效显著优于单用艾司洛尔治疗,且安全性较高,具有一定的临床推广应用价值。

Clinical study on recombinant human brain natriuretic peptide combined with esmolol in treatment of ischemic heart failure

Objective To explore the safety and efficacy of recombinant human brain natriuretic peptide combined with esmolol in treatment of ischemic heart failure. Methods Patients (124 cases) with ischemic heart failure in Pingdingshan Shenma Medical Group General Hospital from October 2015 to October 2016 were randomly divided into control and treatment groups, and each group had 23 cases. Patients in the control group were iv administered with Esmolol Hydrochloride Injection, the first dosage was 0.5 mg/kg, then the continuous intravenous pumping was performed, and the speed was 0.05 mg/(kg·min), adjusted the dose according to the patient's blood pressure and heart rate, and discontinued treatment after clinical symptoms had been relieved. Patients in the treatment group were iv administered with Freeze-dried Recombinant Human Brain Natriuretic Peptide on the basis of the control group, the first dosage was 1.5 μg/kg, then the continuous intravenous pumping was performed, and the speed was 7.5 ng/(kg·min) for 48 h. Patients in two groups were treated for 4 d. After treatment, clinical efficacy, echocardiographic indexes, cardiac function prognosis, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 72.58% and 91.94%, respectively, and there was difference between two groups (P < 0.05). After treatment, the LVEDD, LVESD, and LADD in two groups significantly decreased, but LVEF obviously increased, and the difference was statistically significant in the same group (P < 0.05). And the improvement of these indexes in the treatment group was significantly better than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the NT-proBNP and ET-1 levels in two groups significantly decreased (P < 0.05). And the NT-proBNP and ET-1 levels in treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The clinical efficacy of recombinant human brain natriuretic peptide combined with esmolol in treatment of ischemic heart failure is significantly better than that of esmolol with high safety, which has a certain clinical application value.