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[摘要]
目的 探讨重组人脑钠肽对急性心衰患者心肾功能及脑利钠肽(BNP)的影响。方法 选取2011年1月-2016年12月郑州市第七人民医院收治的急性心力衰竭患者120例。随机分为两组,对照组在常规治疗的基础上给予硝普钠,观察组在常规治疗的基础上给予重组人脑钠肽。用药48 h后,观察两组患者的心功能改善情况、左心室射血分数、血浆BNP水平、排尿量、血肌酐、血钾浓度变化情况。结果 用药后48 h,观察组心功能改善的总有效率为83.34%,显著优于对照组的56.67%,差异有统计学意义(P<0.05)。与用药前相比,两组患者用药后LVEF均明显的升高,组内差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05);用药后两组的血浆BNP水平均明显降低,组内差异有统计学意义(P<0.05),且观察组明显低于对照组,差异有统计学意义(P<0.05);用药后两组的尿量均明显增加,组内差异有统计学意义(P<0.05);且观察组的多于对照组,差异有统计学意义(P<0.05)。与用药前相比,两组患者的血肌酐浓度均轻度升高,观察组血钾浓度轻微升高,对照组血钾浓度轻微下降,差异均无统计学意义;停药后,未见进一步加剧。结论 应用重组人脑钠肽治疗急性心力衰竭患者,可以改善患者的心功能情况,降低血浆BNP水平,利尿,对肾功能未见不良影响。
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[Abstract]
Objective To investigate the influence of BNP and heart and kidney function of recombinant human brain natriuretic peptide on acute heart failure treatment. Methods 120 cases from Jan. 2011 to Dec. 2016 in our hospital were chosen and randomly divided into two groups, the control group were given traditional treatment, the observation group were given brain natriuretic peptide on the basic of traditional treatment. The heart function, left ventricular ejection fraction, plasma BNP, urine output, serum creatinine, blood potassium concentration of two groups were compared. Results After 48 h, the total effective rate of the improvement of cardiac function in the observation group was 83.34%, which was significantly better than that of the control group 56.67%, the difference was statistically significant (P < 0.05). After treatment, the heart function, left ventricular ejection fraction, plasma BNP, urine output of two groups after treatment were better than before treatment (P < 0.05). And the heart function, LVEF ascending range, BNP concentration reduction and urine increased amount of observation group were better than control group (P < 0.05). The serum creatinine concentration of two groups were slighter higher than before, the blood potassium concentration of observation group after treatment was slighter higher than before, the blood potassium concentration of control group was slighter lower than before, which had no significant difference, and after discontinuation which had no further intensified. Conclusion The recombinant human brain natriuretic peptide could be treating for acute heart failure treatment, and improve the heart function, decreased the plasma BNP level, dieresis and which had no adverse reaction on kidney function.
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