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目的比较冻干重组人脑利钠肽联合左西孟旦与单用左西孟旦对急性心力衰竭的疗效及对血清尿酸(UA)和B型利钠肽(BNP)的影响。方法选择2014年4月至2016年10月接诊的90例急性心力衰竭患者作为研究对象,将所有患者按照接受诊治的时间顺序分为观察组和对照组,每组45例,两组患者均给予急性心力衰竭的常规治疗,对照组患者在常规治疗的基础上给予左西孟旦进行治疗,观察组在常规治疗的基础上给予冻干重组人脑利钠肽和左西孟旦进行治疗。观察两组不同用药方案对急性心力衰竭的疗效及对UA和BNP的影响。结果治疗后,观察组总有效率为95.56%(43/45),对照组总有效率为71.11%(32/45),观察组的总有效率明显高于对照组(P<0.01);两组患者在治疗后UA和BNP均有降低,且观察组明显低于对照组(P均<0.05);两组患者治疗后左心室舒张末内径(LVEDD)和左心室射血分数(LVEF)均有所提高,并且观察组患者显著高于对照组(P<0.05或P<0.01);观察组患者出现1例低血压,对照组出现1例低血压,2例头痛,两组不良反应的发生率均较低。结论急性心力衰竭患者,采用冻干重组人脑利钠肽联合左西孟旦治疗临床效果显著,安全性较高,能有效降低UA和BNP水平,改善患者的心功能。
Objective To compare the effects of lyophilized recombinant human brain natriuretic peptide and levosimendan combined with levosimendan on acute heart failure and serum uric acid (UA) and B-type natriuretic peptide (BNP). Methods 90 patients with acute heart failure admitted from April 2014 to October 2016 were selected as study subjects. All the patients were divided into observation group and control group according to the time sequence of receiving diagnosis and treatment. Each group had 45 patients and both groups The patients in the control group were treated with levosimendan on the basis of routine treatment. The observation group was treated with lyophilized recombinant human brain natriuretic peptide and levosimendan on the basis of routine treatment. To observe the curative effect of two different medication regimens on acute heart failure and its effect on UA and BNP. Results After treatment, the total effective rate was 95.56% (43/45) in the observation group and 71.11% (32/45) in the control group. The total effective rate in the observation group was significantly higher than that in the control group (P <0.01) The levels of UA and BNP in both groups decreased after treatment, and the observation group was significantly lower than that of the control group (all P <0.05). The left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) (P <0.05 or P <0.01). One case of hypotension was observed in the observation group and one case of hypotension and two cases of headache in the control group. The incidence of adverse reactions in both groups was significantly higher than that in the control group Rates are lower. Conclusion In patients with acute heart failure, the use of lyophilized recombinant human brain natriuretic peptide combined with levosimendan has significant clinical effect and high safety, which can effectively reduce the levels of UA and BNP and improve the cardiac function in patients.