CAJ | 학술논문

目的探讨重组人脑利钠肽(rhBNP)治疗老年急性心肌梗死泵衰竭患者的效果.方法选取老年急性心肌梗死患者63例,分为治疗组和对照组,治疗组在常规治疗基础上静脉泵入重组人脑利钠肽,对照组在常规治疗基础上泵入硝酸甘油,均应用3～5 d.观察两组患者治疗前后呼吸困难缓解比率、心率、血氧饱和度变化、左室射血分数(LVEF)、左室舒张末容积(LVDD)、血浆白介素6(IL-6)和超敏C反应蛋白(hsCRP)水平.结果治疗组总有效率79.3 ％(23/29),对照组总有效率64.7％(22/34)(P=0.017),治疗组呼吸困难症状缓解优于对照组(P＜0.05);心率、血氧饱和度、LVEF、hsCRP、IL-6治疗组治疗前分别为[(120±11)次/min、(78±6)％、(28±32)％、(25.78±2.44)mg/L、(40.74±5.43) μg/L],治疗后分别为[(89±9)次/min、(97±6)％、(43±20)％、(12.78±2.54) mg/L、(28.45±2.34) μg/L],治疗前后比较均P＜0.05;心率、血氧饱和度、LVEF、hsCRP、IL-6对照组治疗前分别为[(117±8)次/min、(80±8)％、(29±31)％、(21.44±1.33) mg/L、(41.87±5.46) μg/L],治疗后分别为[(109±10)次/min、(34±18)％、(43±20)％、(17.63±1.62) mg/L、(36.56±3.02) μg/I],治疗组在降低心率、hsCRP、IL-6及提高LVEF优于对照组(均P＜0.05).结论重组人脑利钠肽治疗老年急性心肌梗死泵衰竭效果显著.
목적 탐토중조인뇌리납태(rhBNP)치료노년급성심기경사빙쇠갈환자적효과.방법 선취노년급성심기경사환자63례,분위치료조화대조조,치료조재상규치료기출상정맥빙입중조인뇌리납태,대조조재상규치료기출상빙입초산감유,균응용3～5 d.관찰량조환자치료전후호흡곤난완해비솔、심솔、혈양포화도변화、좌실사혈분수(LVEF)、좌실서장말용적(LVDD)、혈장백개소6(IL-6)화초민C반응단백(hsCRP)수평.결과 치료조총유효솔79.3 ％(23/29),대조조총유효솔64.7％(22/34)(P=0.017),치료조호흡곤난증상완해우우대조조(P＜0.05);심솔、혈양포화도、LVEF、hsCRP、IL-6치료조치료전분별위[(120±11)차/min、(78±6)％、(28±32)％、(25.78±2.44)mg/L、(40.74±5.43) μg/L],치료후분별위[(89±9)차/min、(97±6)％、(43±20)％、(12.78±2.54) mg/L、(28.45±2.34) μg/L],치료전후비교균P＜0.05;심솔、혈양포화도、LVEF、hsCRP、IL-6대조조치료전분별위[(117±8)차/min、(80±8)％、(29±31)％、(21.44±1.33) mg/L、(41.87±5.46) μg/L],치료후분별위[(109±10)차/min、(34±18)％、(43±20)％、(17.63±1.62) mg/L、(36.56±3.02) μg/I],치료조재강저심솔、hsCRP、IL-6급제고LVEF우우대조조(균P＜0.05).결론 중조인뇌리납태치료노년급성심기경사빙쇠갈효과현저.
Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide (rhBNP) in the treatment of acute myocardial infarction (AMI) with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy (29 cases) and control (34 cases) groups.Besides routine treatment,the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin.Both drugs were administered for 3-5 days.The dyspnea remission rates after treatment were recorded.At the same time,heart rates and blood oxygen saturation,left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVDD),serum interleukin 6 (IL-6) and high sensitivity C reactive protein (hsCRP) were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 ％ (23/29) in therapy group and 64.7％ (22/34) in control group(P =0.017).The dyspnea remission rate was better in therapy group than in control group (P＜0.05).The heart rate,blood oxygen saturation,LVEF,hsCPR and IL-6 in therapy group were [(120± 11) times/min,(78 ± 6) ％,(28 ± 32) ％,(25.78 ± 2.44) mg/L,(40.74 ± 5.43) μg/L]before treatment,and after treatment [ ( 89 ± 9) times/min,( 97 ± 6 ) ％,(43 ±± 20) ％,( 12.78 ± 2.54 )mg/L,(28.45±2.34) μg/L] (all P＜0.05).The above indexes in control group were [(117±8)times/min,(80±8) ％,(29±31)％,(21.44±1.33) mg/L,(41.87±5.46) μg/L] before treatment,and after treatment[(109± 10) times/min,(34±18) ％,(43±20) ％,(17.63± 1.62) mg/L,(36.56±3.02) μg/L].The heart rate and the levels of IL-6 and hsCPR were reduced,blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.