文章摘要
张 静,陈彩萍,过 晶,高长征,古 忆.心脉隆注射液联合重组人脑钠肽治疗慢性心衰患者的临床观察[J].,2018,(22):4285-4289
心脉隆注射液联合重组人脑钠肽治疗慢性心衰患者的临床观察
Clinical Efficacy of Xinmailong Injection Combined with Recombinant Human Brain Natriuretic Peptide in the Treatment of Chronic Heart Failure
投稿时间:2018-03-28  修订日期:2018-04-25
DOI:10.13241/j.cnki.pmb.2018.22.019
中文关键词: 慢性心衰  心脉隆注射液  重组人脑钠肽  临床疗效
英文关键词: Heart failure  Xinmailong Injection  Recombinant human brain natriuretic peptide  Clinical efficacy
基金项目:南京市医学科技发展项目(YKK12212);江苏省自然科学基金项目(BK20130401)
作者单位E-mail
张 静 江南大学附属医院心内科 江苏 无锡 241000 zjlwzx1@163.com 
陈彩萍 江南大学附属医院心内科 江苏 无锡 241000  
过 晶 江南大学附属医院心内科 江苏 无锡 241000  
高长征 江南大学附属医院心内科 江苏 无锡 241000  
古 忆 东南大学附属南京江北人民医院心内科 江苏 南京 210048  
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中文摘要:
      摘要 目的:探讨心脉隆注射液联合重组人脑钠肽治疗慢性心衰患者的临床效果及对患者心功能、血清N端脑钠肽前体(N-terminal pro b-type natriuretic peptide, NT-proBNP)、胶原、一氧化氮(Nitric oxide, NO)、内皮素-1(endothelin-1, ET-1)水平的影响。方法:选择2015年1月至2017年5月在我院治疗的慢性心衰患者80例,根据随机数字法将其分为对照组和观察组。对照组采用重组人脑钠肽静脉治疗,观察组在此基础上加用心脉隆注射液,治疗14天。观察和比较两组患者治疗前后的心功能指标、血清NT-proBNP、胶原、NO、ET-1水平的变化、临床疗效及不良反应的发生情况。结果:治疗后,观察组总有效率为97.5%,显著高于对照组(82.5%,P<0.05)。治疗前,两组左心射血分数 (left ventricular ejection fraction, LVEF)、每搏输出量(SV, Stroke volume)、心脏指数(CI, Cardiac index)、心率(HR, heart rate)、血清NT-proBNP、NO、ET-1、胶原水平比较差异均无统计学意义(P >0.05);治疗后,两组LVEF、SV、CI、NO均较治疗前明显升高(P<0.05),血清NT-proBNP、ET-1、胶原水平均较治疗前明显下降(P<0.05),且观察组治疗前后各指标的变化幅度均显著高于对照组(P<0.05)。在治疗过程中,对照组出现1例低血压,2例头疼,1例恶心,不良反应发生率为10%;观察组出现1例头痛,不良反应发生率为2.5%,但两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:心脉隆注射液联合重组人脑钠肽治疗慢性心衰的临床疗效显著优于重组人脑钠肽静脉治疗,其可有效降低患者血清NT-proBNP、胶原、ET-1的水平并升高血清NO的水平、改善患者心功能,且安全性更高。
英文摘要:
      ABSTRACT Objective: To investigate the clinical efficacy of Xinmailong injection combined with recombinant human brain natriuretic peptide (rhBNP) in the treatment of patients with chronic heart failure and effect on the serum N-terminal pro-brain natriuretic peptide (NT-proBNP), type I procollagen carboxy terminal peptide (PICP), type Ⅲ procollagen amino terminal peptide (PIIINP), nitric oxide (NO), endothelin-1 (ET-1) levels. Methods: Eighty patients with chronic heart failure were selected in our hospital from January 2015 to May 2017 and divided into the control group and the observation group according to the random number method. The control group was treated with rhBNP, while the observation group was treated with xinmailong injection combined with rhBNP. After two weeks of treatment, the clinical efficacy, incidence of adverse reactions and the changes of serum NT-proBNP, PICP, PIIINP, NO and ET-1 levels in the serum were compared before and after treatment between two groups. Results: After treatment, the total effective rate was 97.5% in the treatment group, which was significantlyResults: higher than 82.5% in the control group(P<0.05). There was no significant difference in the LVEF, SV, CI, HR, serum NT-proBNP, NO, ET-1, PICP and PIIINP levels between the two groups before treatment(P>0.05). After treatment, the levels of LVEF, SV, CI and NO were significantly increased(P<0.05). And the levels of serum NT-proBNP, ET-1, PICP and PIIINP were significantly decreased (P <0.05). The changes of indexes in the observation group were significantly higher than those in the control group after treatment(P<0.05). During treatment, the control group showed 1 case of hypotension, 2 cases of headache, 1 case of nausea, and observation group only showed 1 case of headache. The incidence of adverse reactions in observation group was 2.5%, which was lower than 10% of control group with no significant difference(P>0.05). Conclusion: Xinmailong injection combined with recombinant human brain natriuretic peptide was more effective in the treatment of heart failure than recombinant human brain natriuretic peptide alone, it could reduce the serum levels of NT-proBNP, collagen, ET-1 and increase the serum level of NO, improve the cardiac function without serious adverse reactions.
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