探讨新活素对老年慢性心力衰竭合并糖尿病患者心率变异性的影响及临床疗效观察左权 王新 陈志君(上海中冶医院心内科 上海宝山 200941)

［］目的 观察新活素(冻干重组人脑利钠肽)对慢性心力衰竭合并糖尿病的老年患者心率变异性的影响及其有效性、安全性。方法 将确诊为60例慢性心力衰竭合并2型糖尿病的老年患者随机平均分为2 组：对照组根据慢性心力衰竭和糖尿病指南行基础治疗和有效地控制血糖治疗,干预组在基础治疗联合静滴新活素,观察2组病人的心率变异性变化和心衰的缓解程度、左室舒张末内径、左室射血分数、6分钟步行试验、N端B型钠尿肽前体、24小时尿量等变化。结果 干预组胸闷气短程度改善情况及尿量、左室射血分数、N端B型钠尿肽前体、6分钟步行试验均明细好于对照组,两组患者的心率变异性均降低,但对照组较观察组降低的更明显,心率变异性变化与心衰程度有相关,心衰程度越重,心率变异性值越低。两组无不良反应病人。结论 新活素能够有效的改善老年慢性心力衰竭合并糖尿病患者的症状,能够修复患者自主神经的损伤,安全、有效。

Observation of Clinical effects on heart rate variability of new living factor on the old heart failure patients with diabetes

Objective To observe new live hormone (frozen rhBNP) on chronic heart failure complicated with diabetes in elderly patients with heart rate variability of the impact and effectiveness and safety. Methods Diagnosed 60 cases of type 2 diabetes in elderly patients were randomly divided into chronic heart failure combined for two groups: the control group according to the chronic heart failure and diabetes guidelines based therapy and effectively control blood glucose treatment, the intervention group on the basis of the treatment combined static and new live prime, watch of the patients in the two groups, heart rate variability (HRV) change and heart failure relief degree, left ventricular diastolic diameter (LVDD), left ventricular ejection fraction, 6 minutes walk test, N terminal pro-B-type natriuretic peptide precursor, 24 hours urine volume changes. Results In the intervention group chest tightness, shortness of breath improved and urinary volume, left ventricular ejection fraction (LVEF), N terminal pro-B-type natriuretic peptide precursor, 6 minutes walk test all the details in the control group, heart rate variability (HRV) of patients in the two groups decreased, but the control group than in the observation group decreased more significantly, the changes of heart rate variability and degree of heart failure is related to heart failure and the more severe the degree of, heart rate variability (HRV) value is low. Two groups had no adverse reaction of patients. Conclusion The new active elements can effectively improve the elderly patients with chronic heart failure and diabetes symptoms, can repair the patients with autonomic nervous damage, safe and effective.