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阿托伐他汀联合重组人脑利钠肽治疗急性心肌梗死合并心力衰竭的临床观察
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| 篇名： | 阿托伐他汀联合重组人脑利钠肽治疗急性心肌梗死合并心力衰竭的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察阿托伐他汀联合重组人脑利钠肽（rhBNP）治疗急性心肌梗死（AMI）合并心力衰竭的疗效和安全性。方法：160例AMI合并心力衰竭患者随机分均为A组和B组。A组患者给予肝素、阿司匹林、氯吡格雷等药物，同时限制钠水摄入，给予利尿药、β受体阻滞药，合并呼吸困难者给予面罩吸氧，合并肺感染患者给予抗菌药物等常规治疗；B组患者在A组治疗的基础上给予冻干rhBNP负荷剂量1.5 μg/kg，3 min内静脉推注完，后以0.007 5 μg/（kg·min）维持静脉滴注24 h，连用7 d+每晚睡前服用阿托伐他汀钙片40 mg，每日1次，连用14 d。两组疗程均为14 d。观察两组患者的临床疗效，治疗前后血清前胶原氨基末端肽（PⅢNP）、超敏C反应蛋白（hs-CRP）、去甲肾上腺素（NE）、血肌酐（Cr）、左心室射血分数（LVEF）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）及不良反应发生情况。结果：B组患者总有效率显著高于A组，差异有统计学意义（P＜0.05）。治疗前，两组患者PⅢNP、hs-CRP、NE、Cr、LVEF、LVEDV、LVESV比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者PⅢNP、hs-CRP、NE、Cr、LVEDV、LVESV均显著低于同组治疗前，且B组低于A组；LVEF显著高于同组治疗前，且B组高于A组，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规治疗的基础上，阿托伐他汀联合rhBNP治疗AMI合并心力衰竭疗效显著，可有效提高心输出量，改善心室重塑，且安全性相当。 |
| ABSTRACT： | OBJECTIVE：To observe the efficacy and safety of atorvastatin combined with recombinant human brain natriuretic peptide （rhBNP） in the treatment of acute myocardial infarction （AMI） with heart failure. METHODS：160 AMI patients with heart failure were randomly divided into group A and group B. Group A was given heparin， aspirin， clopidogrel， sodium intake was limited， diuretics and β-blockers were used for anti-heart failure， dyspnea patients were given oxygen masks， and lung infection patients were given antibiotics， and other conventional treatment； group B was additionally given loading dose 1.5 μg/kg rhBNP by intravenous injection within 3 min，and maintained with 0.007 5 μg/（kg·min） for 24 h， for 7 d+40 mg atorvastatin before bed， once a day， for continuous 14 d. The treatment course for both groups was 14 d. Clinical efficacy， serum procollagen amino-terminal peptide （PⅢNP）， high-sensitivity C-reactive protein （hs-CRP）， norepinephrine （NE）， serum creatinine （Cr）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic volume （LVEDV）， left ventricular end-systolic volume （LVESV） before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in group B was significantly higher than group A， the difference was statistically significant（P＜0.05）. Before treatment， there were no significant differences in the PⅢNP， hs-CRP， NE， Cr， LVEF， LVEDV and LVESV between 2 groups（P＞0.05）. after treatment， PⅢNP， hs-CRP， NE， Cr， LVEDV and LVESV in 2 groups were significantly lower than before， and group B was group A， LVEF was significantly higher than before， and group B was higher than group A， the differences were statistically significant （P＜0.05）. And there was no significant difference in the incidence of adverse reactions between 2 groups（P＞0.05）. CONCLUSIONS： Based on the conventional treatment， atorvastatin combined with rhBNP has certain efficacy in the treatment of AMI with heart failure， it can effectively improve cardiac output and ventricular remodeling， with similar safety. |
| 期刊： | 2016年第27卷第9期 |
| 作者： | 王娟，张勇，何江，周立红 |
| AUTHORS： | WANG Juan，ZHANG Yong，HE Jiang，ZHOU Lihong |
| 关键字： | 急性心肌梗死；心力衰竭；阿托伐他汀；重组人脑利钠肽；疗效；安全性 |
| KEYWORDS： | Acute myocardial infarction； Heart failure； Atorvastatin； rhBNP； Efficacy； Safety |
| 阅读数： | 322 次 |
| 本月下载数： | 2 次 |
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