摘要
目的:探讨重组人脑钠肽联合心脉隆注射液对心脏瓣膜置换术患者血清Apelin-12、D-二聚体及心功能的影响。方法:选择2015年8月至2017年8月于我院实施二尖瓣心脏瓣膜置换术的80例患者作为研究对象,通过随机数表法分为观察组(n=40)和对照组(n=40),两组术后均给予常规处理措施,对照组给予心脉隆注射液治疗,观察组联合重组人脑钠肽治疗。比较两组围术期情况、血清氨基末端脑钠肽前体(NT-pro BNP)、血清Apelin-12、D-二聚体、左室射血分数(LVEF)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)及术后不良事件发生率。结果:观察组机械通气时间、住ICU时间、住院时间均明显比对照组短(P<0.05);手术后:两组NT-pro BNP较术前均显著降低(P<0.05),观察组NT-pro BNP明显比对照组低(P<0.05);两组血清Apelin-12、D-二聚体较术前均显著升高(P<0.05),观察组血清Apelin-12、D-二聚体明显比对照组低(P<0.05);两组LVEF较术前均明显降低,CK-MB、cTnI均明显升高(P<0.05),且观察组LVEF明显高于对照组,CK-MB、cTnI明显比对照组低(P<0.05);两组术后1个月感染、低血糖发生率比较无显著差异(P>0.05),观察组心房颤动、血栓发生率明显比对照组低[2.50%(1/40)vs15.00%(6/40),2.50%(1/40)vs17.50%(7/40)](P<0.05)。结论:在心脏瓣膜置换术患者术后使用重组人脑钠肽联合心脉隆注射液效果显著,对心功能具有保护作用,且可降低术后心房颤动、血栓发生率,其内在机制可能和有效控制血清Apelin-12、D-二聚体的升高相关。
Objective： To study the influence of recombinant human brain natriuretic peptide combined with Xinmailong injection on serum Apelin-12,D-dimer and cardiac function in patients with cardiac valve replacement. Methods： 80 patients with mitral valve replacement who received therapy from Aug. 2015 to Aug. 2017 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group（n = 40） and the control group（n = 40）,they were given routine treatment after operation,the control group was treated with Xinmailong injection,while the observation group was combined with recombinant human brain natriuretic peptide. The perioperative condition,serum N-terminal pro brain natriuretic peptide（NT-pro BNP）,serum Apelin-12,D-dimer,left ventricular ejection fraction（LVEF）,creatine kinase isoenzyme（CK-MB）,troponin I（cTnI） and incidence of postoperative adverse events were compared between the two groups. Results： The mechanical ventilation time,ICU time and the hospitalization time in the observation group were significantly shorter than those in the control group（P 0.05）. The NT-pro BNP of two groups were significantly lower than those before the operation（P 0.05）,and the NT-pro BNP in the observation group was significantly lower than those in the control group（P 0. 05）.The serum Apelin-12,D-dimer of two groups were significantly higher than those before the operation（P 0.05）,and the serum Apelin-12,D-dimer in the observation group was significantly lower than those in the control group（P 0.05）; after the operation,the LVEF of two groups were significantly lower than those before the operation,and the CK-MB and cTnI were significantly increased（P 0. 05）,and the LVEF in the observation group was significantly higher than those in the control group,the CK-MB and cTnI was significantly lower than those in the control group（P 0. 05）; 1 months after operation,there was no significant difference in the incidence of infection and hypoglycemia between the two groups（P 0.05）,the incidence of atrial fibrillation and thrombus in the observation group was significantly lower than those in the control group2.50%（1/40） vs 15.00%（6/40）,2.50%（1/40） vs 17.50%（7/40）（P 0.05）. Conclusion： The effect of recombinant human natriuretic peptide combined with heart injection after cardiac valve replacement is significant,and it has protective effect on cardiac function,and can reduce the incidence of atrial fibrillation and thrombus after operation. The internal mechanism may be related to the effective control of the elevation of serum Apelin-12 and D-two polymer.
作者
黄立华
侯秀伟
李伟
HUANG Lihua;HOU Xiuwei;LI Wei(The First Hospital of Jilin University,Jilin Changchun 130021,China)
出处
《河北医学》
CAS
2018年第8期1249-1254,共6页
Hebei Medicine
基金
吉林省科学技术厅资助项目
(编号:20130206025SF)
关键词
心脏瓣膜置换术
重组人脑钠肽
心脉隆注射液
Cardiac valve replacement
Recombinant human brain natriuretie peptide
Xinmailong injection
