重组人脑利钠肽联合左西孟旦治疗脓毒症心力衰竭的效果观察

目的 探讨重组人脑利钠肽(recombinant human brain natriuretic peptide, rh-BNP)联合左西孟旦治疗脓毒症心力衰竭的疗效及安全性，分析其对患者外周血miR-132、miR-31水平的影响。方法 选择2017年3月—2019年6月杭州师范大学附属医院收治的脓毒症并发心力衰竭患者117例，采用随机数字表法分为观察组(61例)和对照组(56例),对照组采用左西孟旦治疗，观察组采用左西孟旦联合rh-BNP治疗。比较2组急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、心功能指标[左室收缩末期内径(left ventricular end systolic diameter, LVESD)、左室舒张末期内径(left ventricular end diastolic diameter, LVEDD)、左室射血分数(left ventricular ejection fraction, LVEF)、左心室短轴缩短率(left ventricular fractio...

Effect of recombinant human brain natriuretic peptide combined with levosimendan in patients with septic heart failure

  Objective  To explore and analyse the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan in the treatment of septic heart failure, and analyse its effect on miR-132 and miR-31 levels in patients' peripheral blood.  Methods  A total of 117 patients with sepsis and heart failure who were admitted at the Affiliated Hospital of Hangzhou Normal University from March 2017 to June 2019 were selected. The random number table method was used to divide the observation group (61 cases) and the control group (56 cases). The control group was treated with levosimendan, and the observation group was treated with levosimendan combined with rh-BNP. The APACHE Ⅱ score, cardiac function indexes, myocardial enzyme spectrum, peripheral blood miR-132 and miR-31 and adverse reactions were compared between the two groups.  Results  After treatment, the APACHE Ⅱ score of the observation group[(14.62±1.74) points] was lower than that of the control group[(16.96±2.73) points, t=5.575, P < 0.05]. The LVEDD[(48.93±4.28) mm], LVESD[(39.42±4.16) mm] and LVFS[(22.31±1.75)%] of the observation group were lower than those of the control group[(52.18±3.95) mm, (42.28±3.74) mm, (24.97±1.89)%, respectively, t=4.257, 3.898, 7.905, all P < 0.05]. The serum LDH, CK and CK-MB levels in the observation group were lower than those in the control group (all P < 0.05). The relative expression of miR-31 in the peripheral blood of patients was positively correlated with LVEDD, LVESD, LDH, CK and CK-MB (all P < 0.05).  Conclusion  rh-BNP combined with levosimendan in the treatment of septic heart failure can effectively improve the clinical symptoms and cardiac function, and it can also improve the expression of miR-132 and miR-31 in the peripheral blood of patients.