重组人脑利钠肽联合硝普钠治疗难治性心力衰竭的临床疗效观察

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目的观察重组人脑利钠肽(rh BNP)联合硝普钠治疗难治性心力衰竭(RHF)的临床疗效。方法选取2014年7月—2015年7月深圳市福田区第二人民医院收治的RHF患者84例,随机分为对照组和观察组,每组42例。在常规抗心力衰竭治疗基础上,对照组患者采用米力农联合硝普钠治疗,观察组患者采用rh BNP联合硝普钠治疗;两组患者均连续治疗72 h。比较两组患者临床疗效,治疗前后每搏输出量、心输出量、左心室射血分数及血清脑尿钠肽、去甲肾上腺素水平,治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者每搏输出量、心输出量、左心室射血分数及血清脑尿钠肽、去甲肾上腺素水平比较,差异无统计学意义(P>0.05);治疗后观察组患者每搏输出量、心输出量、左心室射血分数高于对照组,血清脑尿钠肽、去甲肾上腺素水平低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论 rh BNP联合硝普钠治疗RHF的临床疗效确切,可有效改善患者心功能,且不良反应少。 Objective To observe the clinical efficacy of recombinant human brain natriuretic peptide (rh BNP) combined with sodium nitroprusside in the treatment of refractory heart failure (RHF). Methods From July 2014 to July 2015, 84 patients with RHF admitted to Futian Second People’s Hospital of Shenzhen were randomly divided into control group and observation group, with 42 cases in each group. On the basis of routine anti-heart failure treatment, patients in the control group were treated with Milrinone combined with sodium nitroprusside, and patients in the observation group were treated with rhBNP plus sodium nitroprusside. Patients in both groups were treated for 72 hours continuously. The curative effect, stroke volume, cardiac output, left ventricular ejection fraction, serum brain natriuretic peptide and norepinephrine levels before and after treatment were compared between the two groups. The incidence of adverse reactions during the treatment period was compared. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). Before treatment, stroke volume, cardiac output, left ventricular ejection fraction, serum brain natriuretic peptide and norepinephrine levels were not significantly different between the two groups before treatment (P> 0.05); after treatment, patients in the observation group The volume of stroke, cardiac output and left ventricular ejection fraction were higher than those of the control group. Serum brain natriuretic peptide and norepinephrine levels were lower than those of the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P> 0.05). Conclusion Rh BNP combined with sodium nitroprusside is effective in treating RHF. It can effectively improve the cardiac function of patients with less adverse reactions.
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