摘要
目的评价基因重组人脑利钠肽治疗急性前壁心肌梗死并心力衰竭的临床效果。方法200例急性前壁心肌梗死合并心力衰竭患者随机分为对照组和基因重组人脑利钠肽（rhBNP）组各100例，两组患者均给予常规治疗，rhBNP组在常规治疗基础上给予rhBNP。比较两组心功能改善情况、心脏超声资料、院内不良心脏事件的发生情况及6个月随访情况。结果rhBNP组呼吸困难好转（明显好转36例，好转49例，无好转11例，恶化4例，Ridit值0．4618对0．5382，P=0．043）及Killip分级（明显好转26例，好转56例，无好转14例，恶化4例，Ridit值0．4553对0．5447，P=0．017）在治疗后均好于对照组（呼吸困难好转：明显好转27例，好转46例，无好转20例，恶化7例；Killip分级：明显好转20例，好转45例，无好转25例，恶化10例）；rhBNP组治疗1周时左心室射血分数（LVEF）增加优于对照组[（53．0±5．2）％对（50．0±6．2）％，P：0．014]。住院期间rhBNP组心绞痛（13．0％对27．0％，P=0．013）、心力衰竭（18．0％对32．0％，P=0．022）及心脏主要不良事件发生率（MACE）（17．0％对30．0％，P：0．030）均少于对照组。6个月内无事件存活率rhBNP组高于对照组（69．0％对55．0％，P=0．041）。结论短期使用rhBNP能改善急性前壁心肌梗死心力衰竭患者的心功能，减少住院期间不良心脏事件，增加6个月无事件存活率。
Objective To evaluate the efficacy of intravenous recombinant human brain natriuretic peptide in acute anterior myocardial infarction complicated with heart failure. Methods Two hundred patients suffered from acute anterior myocardial infarction complicated with heart failure were randomly divided into two groups ：rhBNP group （n = 100） and control group （n=100）. All patients were given conventional treatment, patients in rhBNP group were given rhBNP on the basis of conventional therapy. The clinical effectiveness including the improvement of cardiac function, cardiac ultrasound data, the incidence of hospital adverse cardiac events, and six month follow-up were compared between the two groups. Results The degree of decompensation and Killip class in rhBNP group were better than those of control group after treatment （improved dyspnea： significantly improved ：36 vs 27 ; improved ：49 vs 46 ; no improvement ： 11 vs 20 ; deterioration ：4 vs 7 ; Ridit value ： 0. 4618 vs 0. 5382, P = O. 043 ） （ Killip class： significantly improved： 26 vs 20; improved： 56 vs 45; no improvement ： 14 vs 25 ; deterioration ：4 vs 10 ; Ridit value ：0. 4553 vs 0. 5447, P = 0. 017 ）. After treatment for one week ,The LVEF improvement in rhBNP group was more remarkable than that of control group （ [53.0 ± 5.2] % vs. [ 50. 0 ± 6. 2 ] % , P = 0. 014）. The occurrence rate of angina （ 13.0% vs. 27. 0% , P = 0. 013 ）, heart failure （18.0% vs. 32. 0% ,P =0. 022） and major adverse cardiac events（MACE） （17. 0% vs. 30. 0% ,P =0. 030） in rhBNP group was lower than that in control group. During 6 months follow-up period, event-free survival in rhBNP group was higher than that in control group （69.0% vs. 55.0%, P = 0. 041 ）. Conclusion Transvenous injection of rhBNP combined with other routine treatment can improve cardiac function in patients with myocardial infarction in acute anterior myocardial infarction. It can also decrease adverse cardiac events during hospitalization and increase event-free survival in 6 months follow-uo period.
出处
《中国综合临床》
2012年第4期373-376,共4页
Clinical Medicine of China
关键词
心肌梗死
心力衰竭
充血性
重组人脑利钠肽
预后
Myocardial infarction
Heart failure, congestion
Recombinant human brain natriureticpeptide
Prognosis
