摘要
目的探讨新活素(重组人脑钠肽,rhBNP)联合多巴酚丁胺治疗老年急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后并急性左心衰竭的效果。方法抽取2018年2月至2019年10月郑州煤炭工业集团有限责任公司总医院收治的AMI行PCI术后并急性左心衰竭的老年患者66例,按随机数字表法分为常规组(33例,采用多巴酚丁胺+常规治疗)与研究组(33例,在常规组基础上采用rhBNP治疗)。对比两组心功能指标变化和运动耐力、临床疗效、药物不良反应发生率和近期预后不良率。结果治疗前,两组左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、6 min步行距离(6MWT)比较差异均未见统计学意义(P均>0.05);治疗后,两组LVEF和6MWT均增加,LVEDD和LVESD均下降(P均<0.05),且治疗后研究组LVEF和6MWT均高于常规组,LVEDD和LVESD均低于常规组(P均<0.05)。研究组治疗总有效率(90.91%,30/33)高于常规组(66.67%,20/33),P<0.05;研究组与常规组药物不良反应发生率比较差异未见统计学意义(P>0.05),但研究组预后不良率(0,0/30)低于常规组(15.15%,5/33),P<0.05。结论采用rhBNP联合多巴酚丁胺治疗老年AMI患者PCI术后并急性左心衰竭可改善其心功能,增强运动耐力和疗效,安全且可改善近期预后。
Objective To investigate the effects of recombinant human brain natriuretic peptide(rhBNP)combined with dobutamine on acute left heart failure after percutaneous coronary intervention(PCI)in elderly patients with acute myocardial infarction(AMI).Methods A total of 66 elderly AMI patients with acute left heart failure after PCI treated in the General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd.,from February 2018 to October 2019 were selected.Patients were divided into routine group(33 cases,treated with dobutamine on the basis of routine treatment)and study group(33 cases,treated with rhBNP on the basis of routine group)by random number table method.The changes of cardiac function indexes,exercise tolerance,clinical efficacy,incidences of adverse drug reactions and short-term poor prognosis rate were compared between the two groups.Results Before treatment,there was no significant difference in left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)or 6-minute walking distance(6MWT)between the two groups(P>0.05).After treatment,LVEF and 6MWT in both groups increased,LVEDD and LVESD decreased(P<0.05).After treatment,LVEF and 6MWT in study group were higher than those in routine group,however,LVEDD and LVESD in study group were lower than those in routine group(P<0.05).The total effective rate of the study group(90.91%,30/33)was higher than that of the routine group(66.67%,20/33),P<0.05.There was no significant difference in the incidences of adverse drug reactions between the two groups(P>0.05).While the poor prognosis rate of the study group(0,0/30)was lower than that of the routine group(15.15%,5/33),P<0.05.Conclusions rhBNP combined with dobutamine in the treatment of acute left heart failure in elderly AMI patients after PCI can improve heart function,enhance exercise endurance and efficacy,and improve short-term prognosis.
作者
龙春霞
田艳华
刘红菊
Long Chunxia;Tian Yanhua;Liu Hongju(Department of Cardiology,General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd.,Xinmi 452371,China)
出处
《中国实用医刊》
2020年第17期105-108,共4页
Chinese Journal of Practical Medicine
关键词
重组人脑钠肽
多巴酚丁胺
急性心肌梗死
经皮冠状动脉介入治疗
急性左心衰竭
Recombinant human brain natriuretic peptide
Dobutamine
Acute myocardial infarction
Percutaneous coronary intervention
Acute left heart failure
