陆业成　王玉宝　伊善喜

[關键词] 冻干重组人脑利钠肽;急性心梗;心衰;临床效果

[中图分类号] R541.6          [文献标识码] B          [文章编号] 1673-9701（2021）23-0039-03

Efficacy of freeze-dried recombinant human brain natriuretic peptide in treatment of heart failure after acute myocardial infarction

LU Yecheng   WANG Yubao   YI Shanxi

Department of Cardiology， Lianyungang Dongfang Hospital， Lianyungang   222042， China

[Abstract] Objective To explore the clinical effect of freeze-dried recombinant human brain natriuretic peptide in the treatment of heart failure after acute myocardial infarction. Methods Sixty patients with post-acute myocardial infarction heart failure admitted to our hospital from January 2018 to December 2020 were randomly divided into the observation group and the control group， with 30 cases in each group. The control group was given conventional therapy. The observation group was treated with freeze-dried recombinant human brain natriuretic peptide based on the treatment of the control group. The clinical efficacy， left ventricular function， serological indicators， and adverse reactions were compared between the two groups after treatment. Results The total effective rate of clinical treatment in the observation group was significantly better than that in the control group （96.67% vs. 73.33%）， and the difference was statistically significant （P<0.05）. Before treatment， there was no significant difference in LVESD， LVEF， and LVEDD between the two groups of patients （P>0.05）. After treatment， the LVESD and LVEDD in the observation group were lower than those in the control group， and LVEF was higher than the control group （P<0.05）. There was no significant difference in serum indexes （hs-CRP， IL-6， BNP） between the two groups before treatment （P>0.05）. After treatment， the serum levels of hs-CRP， IL-6， and BNP in the observation group were all lower than the control group （P<0.05）. There was no statistically significant difference in the incidence of adverse reactions （6.67% vs. 10.00%） between the observation group and the control group （P>0.05）. Conclusion Freeze-dried recombinant human brain natriuretic peptide has a definite effect on heart failure after acute myocardial infarction. It can significantly improve left ventricular function， reduce inflammatory reactions， and is worthy of application and promotion.

[Key words] Freeze-dried recombinant human brain natriuretic peptide; Acute myocardial infarction; Heart failure; Clinical effect

急性心肌梗死是临床常见的危重症之一，主要是冠状动脉发生病变导致供血异常或中断引发心肌急性缺血，进而影响其正常功能，该疾病发展极为迅速，具有较高的致残率和致死率[1-2]。急性心肌梗死发生后心功能受损导致血清炎性因子水平升高，心脏会出现一系列的代偿反应，病情进一步加重进展而发生心力衰竭[3]。针对心肌梗死后心衰患者，相关指南共识指出应尽早实现心肌再灌注，对于预防或延缓心衰的发生有重要作用，临床常采取抗凝、利尿、扩血管等对症治疗，但对于急性发作患者疗效欠佳，需采取其他药物增进疗效[4-5]。本研究即在常规方案的基础上联用冻干重组人脑利钠肽治疗急性心梗后心衰患者，取得了确切疗效，现报道如下。

1 资料与方法

1.1临床资料

选取我院于2018年1月至2020年12月收治的60例急性心梗后心衰患者，随机分为观察组和对照组，各30例。所有患者均符合心肌梗死和心衰的诊断标准[6]，患者及家属知情同意，排除严重肝肾功能不全及对本研究中药物有过敏史的患者。观察组中男16例，女14例，年龄43～78岁，平均（59.28±5.63）岁;对照组中男17例，女13例，年龄44～79岁，平均（60.15±5.82）岁。两组一般资料比较差异无统计学意义（P>0.05）。本研究经本院医学伦理委员会批准。

1.2 方法

对照组行常规治疗方案，主要包括心电监护、吸氧、扩血管、利尿、抗凝及纠正心衰治疗。观……