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目的分析重组人脑利钠肽治疗急性心肌梗死(心梗)后失代偿性心力衰竭的临床疗效。方法 96例急性前壁心梗后失代偿性心力衰竭患者为研究对象,随机分为对照组和实验组,每组48例。两组均给予抗缺血及利尿常规治疗,对照组在常规治疗基础上联合使用多巴酚丁胺治疗,实验组在常规治疗基础上联合使用重组人脑利钠肽治疗,比较两组患者治疗前及治疗后72 h血脑钠肽(BNP)、左室射血分数(LVEF)、心功能Killip分级,并比较两组患者治疗后30 d内的病死率。结果治疗前两组患者BNP水平、LVEF比较差异无统计学意义(P>0.05);治疗后72 h,两组患者BNP水平明显降低、LVEF明显升高(P<0.05);且实验组患者BNP水平明显低于对照组,LVEF明显高于对照组(P<0.05)。治疗前两组患者心功能Killip分级均为Ⅲ级;而治疗后实验组中Ⅰ级患者比例(62.50%)明显高于对照组(41.67%),Ⅲ级患者比例(10.42%)明显低于对照组(27.08%),心功能Killip分级优于对照组(P<0.05)。两组患者治疗后30d病死率比较差异无统计学意义(P>0.05)。结论相比多巴酚丁胺,重组人脑利钠肽改善急性心梗后失代偿性心力衰竭患者心功能的疗效更显著,且预后效果无差异,值得推广应用。
Objective To analyze the clinical efficacy of recombinant human brain natriuretic peptide in the treatment of decompensated heart failure after acute myocardial infarction (MI). Methods 96 patients with acute anterior myocardial infarction patients with decompensated heart failure were randomly divided into control group and experimental group, 48 cases in each group. Both groups were given anti-ischemic and diuretic conventional treatment, the control group on the basis of conventional treatment combined with dobutamine, the experimental group on the basis of conventional treatment combined with recombinant human brain natriuretic peptide, the treatment of two groups were compared Blood BNP, LVEF and Killip grade were measured before and 72 h after treatment, and the mortality rates within 30 days after treatment were compared between the two groups. Results There was no significant difference in BNP level and LVEF between the two groups before treatment (P> 0.05). At 72 hours after treatment, the levels of BNP and LVEF were significantly increased in both groups (P <0.05) The level was significantly lower than that of control group, LVEF was significantly higher than that of control group (P <0.05). The Killip grade of cardiac function in the two groups before treatment was grade Ⅲ, while in the experimental group, the grade Ⅰ (62.50%) in the experimental group was significantly higher than that in the control group (41.67%), the grade Ⅲ (10.42%) was significantly lower than the control Group (27.08%), Killip grade of cardiac function was better than that of control group (P <0.05). There was no significant difference in mortality rate between the two groups at 30 days after treatment (P> 0.05). Conclusions Compared with dobutamine, recombinant human brain natriuretic peptide can improve the cardiac function of patients with decompensated heart failure after acute myocardial infarction, and has no difference in prognosis. Therefore, it is worth popularizing and applying.