环磷腺苷葡胺对慢性肺源性心脏病住院患者脑钠肽及心率的影响
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摘要
目的观察环磷腺苷葡胺对慢性肺源性心脏病(简称肺心病)合并心衰及快速心律失常患者脑钠肽(BNP)、心率的影响及临床疗效。方法将85例住院肺心病合并心衰及快速心律失常患者,采用随机数字表分为两组,对照组42例,给予常规治疗,观察组43例,在常规治疗的基础上加用环磷腺苷葡胺120 mg加入0.9%生理盐水250 mL内静脉输注,每日1次,14 d为1个疗程。比较治疗前后两组患者临床症状、左室射血分数(LVEF)、血浆BNP、血气分析、呼吸频率及心率等的变化情况。结果两组治疗后临床症状有效率、血气分析指标、呼吸频率等均较治疗前有不同程度改善(P<0.05或0.01),但两组间差异无统计学意义(P>0.05)。两组LVEF、BNP及心率水平较治疗前均下降,且观察组下降幅度较对照组显著(P<0.05或0.01)。结论环磷腺苷葡胺可改善肺心病合并心衰及快速心律失常患者的临床症状及LVEF,降低血浆BNP水平及心率。
Objective To observe the effect of adenosine cyclophosphate on brain natriuretic peptide(BNP) and heart rate in patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia and its clinical efficacy.Methods 85 cases of hospitalized patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia were divided into two groups by random number table.42 cases in control group were given routine treatment,and 43 cases in observation group were given intravenous infusion of adenosine cyclophosphate 120 mg plus 250 mL of 0.9% saline once a day for 14 days on the basis of routine treatment.And then,the changes of clinical symptoms,left ventricular ejection fraction(LVEF),plasma BNP,blood gas analysis,respiratory rate and heart rate were compared between the two groups before and after treatment.Results The effective rate of clinical symptoms,blood gas analysis indexes and respiratory rates of the two groups after treatment improved in different degrees compared with those before treatment(P<0.05 or 0.01),but there was no statistically significant difference between the two groups(P>0.05).The levels of LVEF,BNP and heart rates in the two groups were lower than those before treatment,and the decrease degree of the observation group was more significant than that of the control group(P<0.05 or 0.01).Conclusion Adenosine cyclophosphate can significantly improve clinical symptoms and LVEF of patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia,and reduce plasma BNP level and heart rate.
Objective To observe the effect of adenosine cyclophosphate on brain natriuretic peptide(BNP) and heart rate in patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia and its clinical efficacy.Methods 85 cases of hospitalized patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia were divided into two groups by random number table.42 cases in control group were given routine treatment,and 43 cases in observation group were given intravenous infusion of adenosine cyclophosphate 120 mg plus 250 mL of 0.9% saline once a day for 14 days on the basis of routine treatment.And then,the changes of clinical symptoms,left ventricular ejection fraction(LVEF),plasma BNP,blood gas analysis,respiratory rate and heart rate were compared between the two groups before and after treatment.Results The effective rate of clinical symptoms,blood gas analysis indexes and respiratory rates of the two groups after treatment improved in different degrees compared with those before treatment(P<0.05 or 0.01),but there was no statistically significant difference between the two groups(P>0.05).The levels of LVEF,BNP and heart rates in the two groups were lower than those before treatment,and the decrease degree of the observation group was more significant than that of the control group(P<0.05 or 0.01).Conclusion Adenosine cyclophosphate can significantly improve clinical symptoms and LVEF of patients with chronic pulmonary heart disease complicated with heart failure and tachyarrhythmia,and reduce plasma BNP level and heart rate.
引文
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[11] 周丽艳,谈介凡,戴莉莉.COPD伴肺心病患者血浆脑钠素水平及其临床诊断价值[J].放射免疫学杂志,2011,24(3):324-325.
[12] Maisel AS,Krishnaswany P,Nowak RM,et al.Rapid measurement of B-Type natriuretic peptide in the emergency diagnosis of heart failure[J].N Engl J Med,2002,347(3):161-167.
[13] 白黎峰.血浆脑钠肽检测在慢性肺源性心脏病中的临床意义[J].北方药学,2015,12(2):107.
[14] 李美凤,王子莲,马丽珍,等.检测血清脑钠肽前体在肺心病诊疗中的意义[J].右江医学,2014,42(6):651-654.
[15] 颜秀华.环磷腺苷葡胺治疗慢性肺心病心力衰竭疗效观察[J].吉林医学,2010,31(10):1392-1393.
[2] 张海锋.环磷腺苷葡胺注射液治疗慢性肺心病心肺功能不全的研究[J].中国处方药,2014,12(3):77-78.
[3] Barbma JA,Peinado VI,Santos S.Pulmonary hypertension in chronic obstructive pulmonary disease[J].Eur Respir J,2013,21(5):892-905.
[4] 蔡柏蔷,李龙芸.协和呼吸病学[M].北京:中国协和医科大学出版社,2011:1372-1374.
[5] Abraham WT,Stevenson LW,Bourge RC,et al.Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy:complete follow-up results from the CHAMPION randomised trial[J].Lancet,2016,387(10017):453-461.
[6] 官进喜.前列地尔联合地尔硫卓治疗肺心病心力衰竭的疗效观察[J].中外健康文摘,2010,7(20):216-217.
[7] 毛庆录,徐梅.环磷腺苷葡胺联合地尔硫治疗慢性肺心病心衰合并快速房扑房颤的临床观察[J].中国药房,2015,26(26):3698-3700.
[8] 黄运林.肺心病失代偿期心力衰竭的临床治疗进展[J].中国医药指南,2013,11(7):88-89.
[9] 付永毅,李建强.低分子肝素钠治疗肺源性心脏病心力衰竭疗效观察[J].中国药物与临床,2012,12(6):805-806.
[10] 许文华,李志军.慢性肺源性心脏病并发心律失常68例临床诊断与治疗[J].中国继续医学教育,2015,7(17):130-131.
[11] 周丽艳,谈介凡,戴莉莉.COPD伴肺心病患者血浆脑钠素水平及其临床诊断价值[J].放射免疫学杂志,2011,24(3):324-325.
[12] Maisel AS,Krishnaswany P,Nowak RM,et al.Rapid measurement of B-Type natriuretic peptide in the emergency diagnosis of heart failure[J].N Engl J Med,2002,347(3):161-167.
[13] 白黎峰.血浆脑钠肽检测在慢性肺源性心脏病中的临床意义[J].北方药学,2015,12(2):107.
[14] 李美凤,王子莲,马丽珍,等.检测血清脑钠肽前体在肺心病诊疗中的意义[J].右江医学,2014,42(6):651-654.
[15] 颜秀华.环磷腺苷葡胺治疗慢性肺心病心力衰竭疗效观察[J].吉林医学,2010,31(10):1392-1393.