摘要
目的:观察呋塞米注射液联合重组人B型利钠肽(Recombinant human b-type natriuretic peptide,rhBNP)治疗急性心力衰竭(Acute heart failure,AHF)疗效及对心功能、N末端B型利钠肽原(N-terminal pro-b-type natriuretic peptide,NT-proBNP)、心肌肌钙蛋白I(Cardiac troponin I,cTnI)水平的影响。方法:选取62例2021年1月到2025年1月收治的AHF患者,随机分为常规组和联合组(n=31)。两组均行常规对症治疗,常规组静脉推注呋塞米注射液20 mg,qd,联合组在常规组基础上静脉推注负荷量rhBNP 1.5μg·kg^(-1),继以0.0075-0.010μg·kg^(-1)·min^(-1)速率持续静脉泵入,均治疗14 d。在治疗14 d后观察两组临床疗效,采用心脏彩色多普勒超声评估心功能,包括左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期内径(Left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(Left ventricular end-systolic diameter,LVESD)和心排血量(Cardiac output,CO);采用酶联免疫法检测血清NT-proBNP和cTnI水平,记录两组治疗期间不良反应及随访90 d内主要心血管不良事件(Major adverse cardiac events,MACE)。结果:联合组的治疗总有效率显著高于常规组(P<0.05);治疗14 d后,两组LVEF和CO均显著提升(P<0.05),LVEDD和LVESD均显著下降(P<0.05),且常规组的心功能指标均优于联合组(P<0.05);治疗14 d后,两组NT-proBNP和cTnI水平显著下降(P<0.05),且联合组的血清生物学标志物水平低于常规组(P<0.05);两组治疗期间(14 d)的药物不良反应及随访90 d内的MACE发生率无显著差异(P>0.05)。结论:呋塞米注射液联合rhBNP可有效治疗AHF患者,改善其心功能和心肌损伤,同时安全性良好,具有较高临床应用价值。
Objective:To observe the efficacy of furosemide injection combined with recombinant human B-type natriuretic peptide(rhBNP)in the treatment of acute heart failure(AHF)and its influence on cardiac function and levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI).Methods:Sixty-two patients with AHF were selected from January 2021 to January 2025,and were randomly divided into a conventional group(n=31)and a combined group(n=31).Both groups received conventional symptomatic treatment,and the conventional group was intravenously pumped with 20 mg of furosemide injection once a day,while the combined group was given intravenous pumping with rhBNP at a loading dose of 1.5μg·kg^(-1) and then received continuous intravenous pumping at a rate of 0.0075-0.010μg·kg^(-1)·min^(-1) based on the conventional group.Both groups were treated for 14 days.After 14 days of treatment,the clinical efficacy in the two groups was observed.Cardiac color Doppler ultrasound was used to evaluate the cardiac function,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and cardiac output(CO).The levels of serum NT-proBNP and cTnI were detected by enzyme-linked immunosorbent assay.Adverse reactions during treatment and major adverse cardiac events(MACE)within 90 days of follow-up were recorded in the two groups.Results:The total effective rate of treatment in the combined group was significantly higher than that in the conventional group(P<0.05).After 14 days of treatment,LVEF and CO in the two groups were significantly increased(P<0.05)while LVEDD and LVESD were significantly decreased(P<0.05),and the left ventricular function indexes in the conventional group were better than those in the combined group(P<0.05).After 14 days of treatment,the levels of NT-proBNP and cTnI in the two groups were decreased significantly(P<0.05),and the levels of serum biomarkers in the combined group were lower than those in the conventional group(P<0.05).There were no significant differences in the incidence rates of adverse drug reactions during treatment(14 days)and the incidence rate of MACE within 90 days of follow-up between the two groups(P>0.05).Conclusion:Furosemide injection combined with rhBNP can effectively treat patients with AHF and improve cardiac function and myocardial injury,with good safety and high clinical application value.
作者
饶俊杰
钟海龙
曾宪育
Rao Jun-jie;Zhong Hai-long;Zeng Xian-yu(Emergency Department,Xingguo Second Hospital,Ganzhou 342400,Jiangxi,China;Department of Critical Care Medicine,Xingguo Second Hospital,Ganzhou 342400,Jiangxi,China;Department of Cardiovascular Medicine,Xingguo Second Hospital,Ganzhou 342400,Jiangxi,China)
关键词
呋塞米
重组人B型利钠肽
急性心力衰竭
心功能
临床疗效
Furosemide
Recombinant human B-type natriuretic peptide
Acute heart failure
Cardiac function
Clinical efficacy
