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目的:利用常规药物加心区交感神经阻滞(CSNB)技术治疗(以下简称治疗)慢性心力衰竭,观察治疗前后患者血浆N-端脑利钠肽前体(NT-pro BNP)水平变化情况及利用NT-pro BNP评价常规药物加CSNB对心衰治疗的有效性。方法:对54例慢性心衰患者给予常规药物加CSNB治疗,比较治疗前后血浆NT-pro BNP的水平、左室射血分数(LVEF)、左室舒张末内径(LVEDD)变化情况,随访6个月内不良事件(以下简称事件)发生率(包括全因病死率和再入院率之和)。结果:治疗后患者3-8分钟即感觉呼吸困难等临床症状体征明显减轻,住院期间患者尿量明显增多,无一例死亡;治疗14日及出院时血浆NT-pro BNP明显下降(出院时下降比例为61.4%),与治疗前比较其差异有显著统计学意义(P<0.01);LVEF升高,与治疗前比较其差异有显著统计学意义(P<0.01);住院14日及出院时LVEDD较入院时缩小。随访6个月,发生事件12例(22.2%)。结论:NT-pro BNP是评价心衰治疗有效性的可信指标,常规药物加CSNB治疗心衰的临床疗效明显优于单纯常规药物治疗。
Objective: To observe the changes of plasma N-terminal pro-brain natriuretic peptide (NT-pro BNP) levels before and after treatment in patients with chronic heart failure (CHF) by routine drug plus sympathetic nerve block (CSNB) NT-pro BNP was used to evaluate the effectiveness of conventional drugs plus CSNB in the treatment of heart failure. Methods: 54 patients with chronic heart failure were given conventional therapy plus CSNB. The levels of plasma NT-pro BNP, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were compared before and after treatment. Incidence of adverse events (hereinafter referred to as incidents) (including all-cause mortality and re-admission rates). Results: The symptoms and signs of clinical symptoms such as dyspnea were relieved in 3-8 minutes after treatment. The urinary volume increased significantly during hospitalization without any death. On the 14th day after treatment, the plasma NT-pro BNP was significantly decreased (the rate of decrease at discharge (P <0.01). The difference of LVEF between the two groups was statistically significant (P <0.01), and the difference was statistically significant Narrow compared with admission. Follow-up 6 months, 12 cases occurred (22.2%). Conclusion: NT-pro BNP is a credible index to evaluate the effectiveness of heart failure treatment. The clinical efficacy of conventional drugs plus CSNB in treating heart failure is obviously better than that of conventional drug treatment.