重组人脑利钠肽对改善 ST 段抬高型心肌梗死患者心功能的影响。

Influence of recombinant human B-type natriuretic peptide on improving ventricular function in patients with ST elevation myocardial infarction.

机构信息

Department of Cardiology, Cangzhou Central Hospital, Cangzhou,

出版信息

Eur Rev Med Pharmacol Sci. 2023 Apr;27(8):3420-3429. doi: 10.26355/eurrev_202304_32112.

DOI:10.26355/eurrev_202304_32112

PMID:37140291

Abstract

OBJECTIVE

The aim of this study was to investigate the effect of recombinant human B-type natriuretic peptide (rhBNP) on improving ventricular function in patients with ST-elevation myocardial infarction (STEMI).

PATIENTS AND METHODS

In this retrospective study, 96 patients with STEMI admitted to Cangzhou Central Hospital from June 2017 to June 2019 were recruited and randomized to either a control group or an experimental group, with 48 patients in each group. Patients in both groups were given conventional pharmacological therapy, and an emergency coronary intervention was performed within 12 hours. Patients in the experimental group received rhBNP intravenously postoperatively, whereas patients in the control group received an equal amount of 0.9% NaCl solution through an intravenous drip. Postoperative recovery indicators were compared between the two groups.

RESULTS

Patients treated with rhBNP showed better postoperative respiratory frequency, heart rate, blood oxygen saturation, pleural effusion, acute left heart remodeling after surgery and central venous pressure at 1-3 days after surgery than those without (p<0.05). Early diastolic blood flow velocity/early diastolic motion velocity (E/Em) and wall-motion score indices (WMSI) of patients in the experimental group were markedly lower compared to the control group one week after surgery (p<0.05). Patients receiving rhBNP had better left ventricular ejection fraction (LVEF) and WMSI six months after surgery and higher left ventricular end diastolic volume (LVEDV) and LVEF one week after surgery than the controls (p<0.05). Administration of rhBNP for patients with STMI provided a higher treatment safety by significantly reducing the incidence of left ventricular remodeling and complication than conventional medication (p<0.05).

CONCLUSIONS

Intervention with rhBNP in STEMI patients could effectively inhibit ventricular remodeling, alleviate symptoms, reduce adverse complications and improve ventricular function.

摘要

目的

本研究旨在探讨重组人脑利钠肽（rhBNP）对改善 ST 段抬高型心肌梗死（STEMI）患者心室功能的作用。

患者与方法

本回顾性研究共纳入 2017 年 6 月至 2019 年 6 月期间在沧州市中心医院就诊的 96 例 STEMI 患者，并将其随机分为对照组和实验组，每组 48 例。两组患者均接受常规药物治疗，并在发病 12 小时内行急诊经皮冠状动脉介入治疗。实验组患者术后静脉注射 rhBNP，对照组患者则静脉滴注等量 0.9%氯化钠溶液。比较两组患者术后恢复指标。

结果

rhBNP 治疗组患者术后呼吸频率、心率、血氧饱和度、胸腔积液、术后急性左心重构及术后 1-3 天中心静脉压均优于无 rhBNP 治疗组（p<0.05）。实验组患者术后 1 周的早期舒张血流速度/早期舒张运动速度（E/Em）和壁运动评分指数（WMSI）明显低于对照组（p<0.05）。rhBNP 治疗组患者术后 6 个月左心室射血分数（LVEF）和 WMSI 明显优于对照组，术后 1 周左心室舒张末期容积（LVEDV）和 LVEF 明显高于对照组（p<0.05）。rhBNP 治疗 STMI 患者较常规药物治疗可显著降低左心室重构及并发症发生率，从而提高治疗安全性（p<0.05）。