[1]陶 涛,刘毅龙.重组人脑利钠肽联合沙库巴曲缬沙坦钠片治疗冠状动脉粥样硬化性心脏病心力衰竭疗效观察[J].新乡医学院学报,2022,39(3):258-263.[doi:10.7683/xxyxyxb.2022.03.012]
 TAO Tao,LIU Yilong.Effect of recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium tablet in the treatment of patients with heart failure caused by coronary atherosclerotic heart disease[J].Journal of Xinxiang Medical University,2022,39(3):258-263.[doi:10.7683/xxyxyxb.2022.03.012]
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重组人脑利钠肽联合沙库巴曲缬沙坦钠片治疗冠状动脉粥样硬化性心脏病心力衰竭疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年3
页码:
258-263
栏目:
临床研究
出版日期:
2022-03-05

文章信息/Info

Title:
Effect of recombinant human brain natriuretic peptide combined with sacubitril valsartan sodium tablet in the treatment of patients with heart failure caused by coronary atherosclerotic heart disease
作者:
陶 涛刘毅龙
(西安市中医医院心血管内科,陕西 西安 710016)
Author(s):
TAO TaoLIU Yilong
(Department of Vasculocardiology,Xi′an Hospital of Traditional Chinese Medicine,Xi′an 710016,Shaanxi Province,China)
关键词:
冠状动脉粥样硬化性心脏病心力衰竭重组人脑利钠肽沙库巴曲缬沙坦钠片心锚重复蛋白偶联因子6心功能
Keywords:
coronary atherosclerotic heart diseaseheart failurerecombinant human brain natriuretie peptidesacubitril valsartan sodium tabletcardiac ankyrin repeat proteincoupling factor 6heart function
分类号:
R541.4
DOI:
10.7683/xxyxyxb.2022.03.012
文献标志码:
A
摘要:
目的 探讨重组人脑利钠肽(rhBNP)联合沙库巴曲缬沙坦钠片治疗冠状动脉粥样硬化性心脏病心力衰竭的临床效果。方法 选择2016年1月至2019年12月西安市中医医院收治的123例冠状动脉粥样硬化性心脏病心力衰竭患者为研究对象,根据治疗方法将患者分为A组、B组和C组,每组41例。所有患者给予吸氧、利尿、纠正水电解质紊乱及酸碱失衡、强心、抗血小板聚集等常规治疗措施,在常规治疗基础上,A组患者给予沙库巴曲缬沙坦钠片治疗,B组患者给予rhBNP治疗,C组患者给予沙库巴曲缬沙坦钠片和rhBNP联合治疗,3组患者均治疗4周。治疗后评估3组患者的临床疗效,并观察治疗期间患者不良反应发生情况。治疗前和治疗后,应用彩色多普勒超声诊断仪检测患者左心室射血分数(LVEF)、心输出量(CO)、每博输出量(SV)和心脏指数(CI),采用酶联免疫吸附试验测定血清心锚重复蛋白(CARP)、醛固酮(ALD)、细胞间黏附分子-1(ICAM-1)水平,采用放射免疫法测定血清线粒体偶联因子6(CF6)水平,采用明尼苏达生活质量量表(MLHFQ)评估患者的生活质量,并测量患者6 min步行距离(6MWD)。结果 A组、B组和C组患者治疗总有效率分别为75.61%(31/41)、78.05%(32/41)、95.12%(39/41),C组患者治疗总有效率显著高于A组和B组(χ2=6.248、5.145,P<0.05),A组与B组患者治疗总有效率比较差异无统计学意义(χ2=0.069,P>0.05)。治疗前3组患者的LVEF、SV、CO、CI比较差异无统计学意义(P>0.05),3组患者治疗后的LVEF、SV、CO、CI显著高于治疗前(P<0.05);治疗后,C组患者的LVEF、SV、CO、CI显著高于A组和B组(P<0.05),A组与B组患者的LVEF、SV、CO、CI比较差异无统计学意义(P>0.05)。治疗前3组患者血清CF6、CARP、ALD和ICAM-1水平比较差异无统计学意义(P>0.05),3组患者治疗后血清CF6、CARP、ALD和ICAM-1水平显著低于治疗前(P<0.05);治疗后,C组患者血清CF6、CARP、ALD和ICAM-1水平显著低于A组和B组(P<0.05),A组与B组患者血清CF6、CARP、ALD和ICAM-1水平比较差异无统计学意义(P>0.05)。治疗前3组患者MLHFQ评分、6MWD比较差异无统计学意义(P>0.05);3组患者治疗后MLHFQ评分显著低于治疗前,6MWD显著大于治疗前(P<0.05);治疗后C组患者MLHFQ评分显著低于A组和B组,6MWD显著大于A组和B组(P<0.05);治疗后A组与B组患者MLHFQ评分、6MWD比较差异无统计学意义(P>0.05)。治疗期间,A组、B组和C组患者不良反应发生率分别为14.63%(6/41)、9.76%(4/41)、17.07%(7/41),3组患者不良反应发生率比较差异无统计学意义(χ2=0.956,P>0.05)。结论 rhBNP和沙库巴曲缬沙坦钠片联合治疗可以有效改善冠状动脉粥样硬化性心脏病心力衰竭患者的心功能,提高患者的运动能力和生活质量。
Abstract:
Objective To investigate the clinical effect of recombinant human brain natriuretie peptide (rhBNP) combined with sacubitril valsartan sodium tablet in the treatment of patients with heart failure caused by coronary atherosclerotic heart disease.Methods A total of 123 patients with coronary atherosclerotic heart disease and heart failure treated in Xi′an Hospital of Traditional Chinese Medicine from January 2016 to December 2019 were selected as the research subjects,and the patients were divided into group A,group B and group C according to the treatment methods,with 41 cases in each group.All patients were treated with routine treatment measures such as oxygen inhalation,diuresis,correcting fluid-electrolyte disorder and acid-base imbalance,cardiotonic and antiplatelet aggregation.On the basis of routine treatment,the patients in the group A were treated with sacubitril valsartan sodium tablets,and the patients in the group B were treated with rhBNP;and the patients in the group C were treated with sacubitril valsartan sodium tablets and rhBNP;the patients in the three groups were treated for four weeks.The clinical effect of the patients in the three groups was evaluated after treatment,and the adverse reactions during treatment were observed.Before and after treatment,the left ventricular ejection fraction (LVEF),cardiac output (CO),stroke volume (SV) and cardiac index (CI) were measured by color Doppler ultrasound diagnostic instrument.The levels of serum cardiac ankyrin repeat protein (CARP),aldosterone (ALD) and intercellular adhesion molecule-1 (ICAM-1) were detected by enzyme-linked immunosorbent assay.The level of serum mitochondrial coupling factor 6 (CF6) was detected by radioimmunoassay,and the quality of life was assessed by Minnesota living with heart failure questionnaire (MLHFQ),and the 6-minute walking distance (6MWD) of patients was measured.Results The total effective rates of patients in the group A,group B and group C were 75.61% (31/41),78.05% (32/41) and 95.12% (39/41),respectively.The total effective rate of patients in the group C was significantly higher than that in the group A and group B (χ2=6.248,5.145;P<0.05),and there was no significant difference in the total effective rate between group A and group B (χ2=0.069,P>0.05).There was no significant difference in the LVEF,SV,CO and CI among the three groups before treatment (P>0.05); the LVEF,SV,CO and CI of patients in the three groups after treatment were significantly higher than those before treatment (P<0.05).After treatment,the LVEF,SV,CO,and CI in the group C were significantly higher than those in the group A and group B (P<0.05);and there was no significant difference in LVEF,SV,CO and CI between the group A and group B (P>0.05).There was no significant difference in the levels of serum CF6,CARP,ALD and ICAM-1 among the three groups before treatment (P>0.05).The levels of serum CF6,CARP,ALD and ICAM-1 in the three groups after treatment were significantly lower than those before treatment (P<0.05).After treatment,the levels of serum CF6,CARP,ALD and ICAM-1 in the group C were significantly lower than those in the group A and group B (P<0.05);there was no significant difference in the levels of serum CF6,CARP,ALD and ICAM-1 between the group A and group B (P>0.05).There was no significant difference in MLHFQ score and 6MWD among the three groups before treatment (P>0.05).The MLHFQ score in the three groups after treatment was significantly lower than that before treatment,and the 6MWD was significantly greater than that before treatment (P<0.05).After treatment,the MLHFQ score in the group C was significantly lower than that in the group A and group B,and the 6MWD in the group C was significantly greater than that in the group A and group B (P<0.05),but there was no significant difference in MLHFQ score and 6MWD between the group A and group B (P>0.05).During treatment,the incidence of adverse reactions in the group A,group B and group C was 14.63% (6/41),9.76% (4/41) and 17.07% (7/41),respectively.There was no significant difference in the incidence of adverse reactions among the three groups (χ2=0.956,P>0.05).Conclusion The combined treatment of rhBNP and sacubitril valsartan sodium tablet can effectively improve the heart function,exercise ability and quality of life of patients with coronary atherosclerotic heart disease and heart failure.

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更新日期/Last Update: 2022-03-05