2019 年第 1 期 第 14 卷

无创血流动力学监测评价心脉隆注射液和冻干重组人脑利钠肽治疗缺血性心力衰竭的临床效果

Clinical effects of Xinmailong injection and lyophilized recombinant human brain natriuretic peptide on ischemic heart failure evaluated by non-invasive hemodynamic monitoring

作者：林明宽刘浩梁柳丹张华吉晓理晏君张明哲魏静

英文作者：

单位：572000海南省三亚市人民医院心内科（林明宽、梁柳丹、张华、吉晓理、晏君、张明哲、魏静）；530007南宁，广西医科大学第二附属医院心内科（刘浩）

英文单位：

关键词：缺血性心力衰竭；冻干重组人脑利钠肽；心脉隆注射液；心功能；无创心排血量

英文关键词：

• 摘要：

• 【摘要】目的    通过无创血流动力学监测评价心脉隆注射液和冻干重组人脑利钠肽治疗缺血性心力衰竭的临床效果。方法    选取2015年2月至2017年2月海南省三亚市人民医院收治的缺血性心力衰竭患者96例，按照随机数字表法分为对照组和观察组，各48例。对照组给予常规药物+冻干重组人脑利钠肽治疗；观察组给予常规药物+心脉隆注射液治疗，均治疗5 d。观察2组治疗前后无创心功能监测指标、N末端B型脑钠肽前体（NT-proBNP）、尿量、血尿酸、血钠水平及治疗过程中的不良反应。结果    观察组治疗第5天左心室射血分数、治疗第4天和第5天心排血量、治疗第5天心排血指数高于对照组同时间［（0.52±0.08）%比（0.46±0.16）%、（3.24±0.44）L/min比（2.72±0.38）L/min、（3.36±0.45）L/min比（2.68±0.34）L/min、（2.8±0.6）L/(min·m2)比（2.2±0.5）L/(min·m2)］，治疗第4天和第5天外周血管阻力、外周血管阻力指数高于对照组［（1 652±325）DS/cm5比（1 546±320）DS/cm5、（1 654±324）DS/cm5比（1 510±310）DS/cm5、（2 796±421）DS/（min2·m5）比（2 052±418）DS/（min2·m5）、（2 624±419）DS/（min2·m5）比（2 045±404）DS/（min2·m5）］，差异均有统计学意义（均P<0.05）。治疗后，观察组NT-proBNP、血尿酸均低于对照组，尿量高于对照组，差异均有统计学意义（均P<0.05）。所有患者治疗过程中未出现恶性心律失常、心力衰竭恶化、急性冠状动脉综合征等不良反应。结论    在缺血性心力衰竭患者治疗过程中心脉隆注射液能够明显改善心脏射血功能、心排血量、心排血指数；而重组人脑利钠肽能明显降低患者的外周血管阻力。

• 【Abstract】Objective    To investigate the clinical effects of Xinmailong injection and lyophilized recombinant human brain natriuretic peptide(rhBNP) on ischemic heart failure evaluated by non-invasive hemodynamic monitoring. Methods    From February 2015 to February 2017, 96 patients with ischemic heart failure in Sanya People′s Hospital were randomly divided into control group and observation group, with 48 cases in each group. On the basis of routine medication, the control group was treated with rhBNP and the observation group was treated with Xinmailong injection for 5 days. Non-invasive cardiac function indicators, N-terminal brain natriuretic peptide precursor (NT-proBNP), urine volume, serum uric acid, serum sodium and adverse reactions were analyzed. Results    During treatment, left ventricular ejection fraction on the 5th day, cardiac output on the 4th and 5th days, cardiac index on the 5th day in observation group were significantly higher than those in control group［（0.52±0.08）% vs （0.46±0.16）%, （3.24±0.44）L/min vs （2.72±0.38）L/min, （3.36±0.45）L/min vs （2.68±0.34）L/min, （2.8±0.6）L/(min·m2) vs （2.2±0.5）L/(min·m2)］; systemic vascular resistance and systemic vascular resistance index on the 4th and 5th days in observation group were significantly higher than those in control group［（1 652±325）DS/cm5 vs （1 546±320）DS/cm5, （1 654±324）DS/cm5 vs （1 510±310）DS/cm5, （2 796±421）DS/（min2·m5） vs （2 052±418）DS/（min2·m5）, （2 624±419）DS/（min2·m5） vs （2 045±404）DS/（min2·m5）］(all P<0.05). After treatment, NT-proBNP level and serum uric acid level in observation group were significantly lower and urine volume was higher than those in control group(all P<0.05). No adverse reactions such as malignant arrhythmia, deterioration of heart failure and acute coronary syndrome occurred during treatment. Conclusion    Xinmailong injection can significantly improve cardiac ejection, cardiac output and cardiac index, while lyophilized recombinant human brain natriuretic peptide can significantly reduce peripheral vascular resistance in the treatment of ischemic heart failure.