新活素与多巴酚丁胺治疗急性心力衰竭的疗效比较及对血浆Gal-3、CysC、ET-1水平的影响

目的:分析和比较新活素(Lrh-BNP)与多巴酚丁胺(Dob)治疗急性心力衰竭(AHF)的临床效果及对其血浆半乳糖凝集素(Gal)-3、胱抑素C(CysC)、内皮素(ET)-1水平的影响。方法:选取我院2015年2月~2017年2月收治的114例AHF患者,采用随机数字表法均分为两组。Dob组给予Dob治疗,Lrh-BNP组予以Lrh-BNP治疗。比较两组治疗前后心功能参数,血浆Gal-3、CysC、ET-1水平,临床综合疗效及不良反应的发生情况。结果:与治疗前相比,两组治疗72h后FS、LVEF值均显著升高(P0.01),LVEDD、血浆Gal-3、CysC、ET-1水平均显著降低(P0.01),且Lrh-BNP组以上指标较对照组改善更显著(P0.01)。治疗72h后,Lrh-BNP组总有效率为89.5%,较Dob组明显上升(73.7%,P0.05)。两组不良反应发生率相比差异无统计学意义(P0.05)。结论:与多巴酚丁胺相比,新活素治疗急性心力衰竭的疗效更好,安全性相当,可能与其有效降低患者血浆Gal-3、CysC、ET-1水平有关。

Comparison of Clinical Efficacy of Lyophilized Recombinant Human Brain Natriuretic Peptide and Dobutamine in Treatment of Acute Heart Failure and Plasma Gal-3, CysC and ET-1 Levels

ABSTRACT Objective: To explore and compare the clinical efficacy of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP) and dobutamine (Dob) in the treatment of patients with acute heart failure (AHF) and impacts on the plasma galectin (Gal)-3, Cystatin C (CysC) and endothelin (ET-)-1 levels. Methods: 114 cases of patients with AHF in our hospital from February 2015 to February 2017 were selected as the research objectives and randomly divided into two groups. Dob group was treated by Dob, while Lrh-BNP group was treated by Lrh-BNP. The cardiac function parameters, plasma Gal-3, CysC, ET-1 levels before and after treatment, clinical comprehensive efficacy and incidence of adverse reactions were compared between two groups. Results: The FS, LVEF levels of both groups at 72 hours after treatment were significantly higher than those before treatment (P<0.01), but the LVEDD, plasma Gal-3, CysC, ET-1 levels were obviously decreased (P<0.01), the index mentioned above of Lrh-BNP group improved more significantly than those of the Dob group(P<0.01). The overall effective rate of Lrh-BNP group was 89.5 %, which was significantly higher than that of the Dob group(73.7%, P<0.05). No significant difference was found in the incidence of adverse reaction between two groups(P>0.05). Conclusion: Lyophilized recombinant human brain natriuretic peptide was more effective in the treatment of AHF than Dobutamine with equal safety, which might be related to the decrease of plasma Gal-3, CysC, ET-1 levels.