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目的探索重组人脑利钠肽(rh BNP)在急性心肌梗死(AMI)后心力衰竭(HF)治疗中的应用价值。方法纳入我院2013年1月-2014年8月期间收治的64例AMI后HF患者,随机分为治疗组和对照组,每组各32例。对照组予常规抗心衰治疗,治疗组在此基础上加用rh BNP,以临床疗效及治疗前后N-末端脑利钠肽前体(NT-pro BNP)、C反应蛋白(CRP)、左心室射血分数(LVEF)和左心室舒张末内径(LVDD)等指标的变化评价联用rh BNP的价值。结果治疗后,治疗组总有效率(87.5%)明显高于对照组(65.6%),组间差异有统计学意义(P<0.05);两组LVEF均明显升高(P<0.05),且治疗组LVEF[(55.40±9.40)%]显著高于对照组[(50.60±8.40)%];两组患者LVDD、NT-pro BNP和CRP指标均显著降低(P<0.05),且治疗组LVDD、NT-pro BNP、CRP[分别为(48.10±6.20)mm、(3 082.41±258.92)pg/ml和(3.02±0.56)mg/L]相比对照组LVDD、NT-pro BNP、CRP[(51.00±6.40)mm、(3 746.58±469.58)pg/L和(3.24±0.75)mg/L]下降更为显著,组间差异均有统计学意义(P<0.05)。结论常规抗心衰治疗方案联合静脉用rh BNP治疗AMI后HF疗效好且安全,值得进一步研究和推广。
Objective To explore the value of recombinant human brain natriuretic peptide (rh BNP) in the treatment of heart failure (HF) after acute myocardial infarction (AMI). Methods Sixty-four patients with HF after AMI admitted to our hospital from January 2013 to August 2014 were randomly divided into treatment group and control group, with 32 cases in each group. The patients in the control group were given conventional anti-heart failure treatment. The treatment group was given rhBNP on the basis of the above results. The clinical efficacy and the levels of NT-proBNP, C-reactive protein (CRP) Ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVDD) and other indicators of changes in evaluation of the value of rh BNP. Results After treatment, the total effective rate (87.5%) in the treatment group was significantly higher than that in the control group (65.6%), with significant difference between the two groups (P <0.05); LVEF in both groups was significantly increased (P <0.05) The LVEF [(55.40 ± 9.40)%] in the treatment group was significantly higher than that in the control group [(50.60 ± 8.40)%]; the LVDD, NT-pro BNP and CRP were significantly lower in both groups (P <0.05) , BNP, CRP [(48.10 ± 6.20) mm, (3 082.41 ± 258.92) pg / ml and (3.02 ± 0.56) mg / L] 51.00 ± 6.40) mm, (3 746.58 ± 469.58) pg / L and (3.24 ± 0.75) mg / L, respectively. There was significant difference between the two groups (P <0.05). Conclusion Conventional anti-heart failure treatment regimen combined with intravenous rh BNP for the treatment of AMI is effective and safe and worthy of further study and promotion.