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目的探讨重组人脑钠肽治疗慢性心力衰竭急性失代偿性重症患者的临床疗效。方法选取2014年1月至2016年1月江阴市人民医院收治的慢性心力衰竭急性失代偿性重症患者92例为研究对象,按随机数字表法分为对照组与观察组,每组46例。观察组患者静脉推注重组人脑钠肽,对照组患者静脉推注米力农,比较两组患者的临床疗效、血流动力学参数及临床指标。结果观察组患者的总有效率为87.0%,对照组为60.9%,观察组的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者心肌纵向应变率、心脏指数、每搏输出量改善明显优于对照组,差异均有统计学意义(均P<0.05)。两组患者尿量、心率比较,差异有统计学意义(P<0.05);平均动脉压差异无统计学意义(P>0.05)。两组患者血浆脑钠肽、左心射血分数比较,差异均有统计学意义(均P<0.05);左心室舒张末期内径差异无统计学意义(P>0.05)。结论采用重组人脑钠肽治疗慢性心力衰竭急性失代偿性重症患者效果显著,能明显改善患者的心功能,缓解临床症状。
Objective To investigate the clinical efficacy of recombinant human brain natriuretic peptide in patients with acute decompensated severe chronic heart failure. Methods Ninety-two patients with acute decompensated severe chronic heart failure admitted to Jiangyin People’s Hospital from January 2014 to January 2016 were selected as subjects and divided into control group and observation group according to random number table method, with 46 cases in each group . Patients in the observation group were intravenously injected with recombinant human brain natriuretic peptide, while those in the control group were given intravenous injection of milrinone. The clinical efficacy, hemodynamic parameters and clinical indexes were compared between the two groups. Results The total effective rate was 87.0% in the observation group and 60.9% in the control group. The total effective rate in the observation group was higher than that in the control group (P <0.05). The longitudinal strain rate, cardiac index and stroke volume in the observation group were significantly better than those in the control group (all P <0.05). The urine output and heart rate of the two groups were significantly different (P <0.05). The mean arterial pressure had no significant difference (P> 0.05). Plasma BNP and left ventricular ejection fraction were significantly different between the two groups (all P <0.05). There was no significant difference in left ventricular end-diastolic diameter between the two groups (P> 0.05). Conclusion The recombinant human brain natriuretic peptide is effective in treating patients with acute decompensated severe chronic heart failure and can significantly improve the patient’s cardiac function and relieve the clinical symptoms.