新活素治疗老年急性左心功能不全的疗效观察

作者单位:110000 沈阳,辽宁中置盛京老年病医院有限公司

 左心功能不全;急性;新活素;重组人脑利钠肽;老年

Clinical Effect of Recombinant Human Brain Natriuretic Peptide on Acute Left Ventricular Insufficiency in Elderly Patients
ZHANG Ying

(Liaoning Zhongzhi Shengjing Geriatric Hospital Co., Ltd, Shenyang 110000, Liaoning Province, China)

 Left Ventricular Dysfunction; Acute; Recombinant Human Brain Natriuretic Peptide ; Old Age

DOI: 10.3969/j.issn.1672-7185.2020.02.018

备注

 目的  探讨新活素对老年急性左心功能不全(A LVD)血流动力学和肾功能的改善情况。方法  收集辽宁中置盛京老年病医院2017年1月—2018年12月收治的老年A L VD患者80例,随机分为对照组和观察组各40例。对照组采用强心、利尿、扩血管等基础治疗,观察组在此基础上接受新活素治疗,比较两组治疗后的血流动力学和肾功能改善情况。结果  两组治疗7 d后收缩压、舒张压、平均动脉压、中心静脉压和肺毛细血管楔压均较治疗前下降;左室射血分数、心输出量、心指数均较治疗前升高,组间差异均有统计学意义(P<0.05)。两组治疗3 d、5 d、7 d后肌酐差异有统计学意义( P<0.05);治疗5 d、7 d后尿素氮差异有统计学意义( P<0.05)。结论  新活素能够迅速改善老年ALVD患者的血流动力学情况,并且发挥一定程度的肾脏保护作用。
 Objective  To investigate the effect of recombinant human brain natriuretic peptide in improving of hemodynamic and renal function in elderly patients with acute left ventricular insufficiency (ALVD). Methods  A total of 80 elderly patients with ALVD admitted to our hospital from Jan 2017 to Dec 2018 were randomly divided into control group and observation group, 40 cases in each group. The control group was treated with cardiotonic, diuretic, vasodilator and other basic treatment, while observation group was treated with recombinant human brain natriuretic peptide on basic treatment. The hemodynamics and renal function improvement after treatment were compared between the two groups. Results  Systolic blood pressure, diastolic blood pressure, mean arterial pressure, central venous pressure and pulmonary capillary pressure significantly decreased after 7 days of treatment in both groups, while left ventricular ejection fraction, cardiac output and cardiac index significantly increased after 7 days of treatment (P<0.05). There was significant difference in creatinine between the two groups after 3, 5 and 7 days of treatment (P<0.05), while there was significant differences in urea nitrogen after 5 and 7 days of treatment (P<0.05). Conclusion  The recombinant human brain natriuretic peptide can rapidly improve the hemodynamics of elderly ALVD patients and exert a certain degree of renal protection.