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目的探讨微量泵泵入利尿合剂对难治性心力衰竭(CHF)患者B型脑钠肽(BNP)的影响。方法选择经1～2周正规抗CHF治疗,心功能Ⅲ一Ⅳ级患者70例,将其分为常规治疗组35例,利尿合剂治疗组35例(常规治疗加利尿合剂)。治疗前后测定BNP、平均心率、心律失常发生率及左心室射血分数(LVEF),治疗后判断疗效情况。结果利尿合剂治疗组显效率,及总有效率为71.4%和88.5%,均高于常规治疗组的40.0%和70.1%(P<0.05),两组中反映心功能及病情变化的相关指标均有所改善,但前者改善更加明显(P<0.01,P<0.05),其中,BNP下降幅度最显著(P<0.05)。结论难治性心力衰竭患者在常规治疗基础上加用利尿合剂,可明显改善心功能,更大程度地降低BNP水平。BNP对于评价心力衰竭的治疗反应具有一定参考价值。
Objective To investigate the effect of micropump pump pumped into diuretic mixture on brain natriuretic peptide (BNP) in patients with refractory heart failure (CHF). Methods Seventy patients with formal-anti-CHF treatment of 1 ~ 2 weeks and Ⅲ ~ Ⅳ cardiac function were divided into 35 cases in the conventional treatment group and 35 cases in the diuretic mixture treatment group. BNP, mean heart rate, arrhythmia incidence and left ventricular ejection fraction (LVEF) were measured before and after treatment. The therapeutic effect was evaluated after treatment. Results The effective rate and the total effective rate of the diuresis mixture treatment group were 71.4% and 88.5%, respectively, which were higher than those of the conventional treatment group (40.0% and 70.1%, P <0.05). The relative indexes reflecting the changes of cardiac function and disease in both groups (P <0.01, P <0.05). However, the decline of BNP was the most significant (P <0.05). Conclusions Patients with refractory heart failure treated with diuretic combination therapy on the basis of routine treatment can significantly improve cardiac function and reduce the level of BNP to a greater extent. BNP has some reference value for evaluating the therapeutic response of heart failure.