环磷腺苷葡甲胺联合重组人脑利钠肽治疗冠心病心衰疗效评价

J4 ›› 2011, Vol. 37 ›› Issue (4): 723-726.

环磷腺苷葡甲胺联合重组人脑利钠肽治疗冠心病心衰疗效评价

丁大植^1,2,丁江山³,金振一^1,秦孝智^1,关立克¹,崔勋²

1. 延边大学附属医院心血管内科,吉林延吉 133000;2.延边大学长白山生物资源和功能分子教育部重点实验室吉林延吉 133000;3.中国人民解放军第3305工厂职工医院心内科,吉林敦化 133709

收稿日期:2011-03-22 出版日期:2011-07-28 发布日期:2011-07-28
通讯作者: 崔勋 (Tel:0433-2660584,E-mail:cuixun@ybu.edu.cn) E-mail:cuixun@ybu.edu.cn
作者简介:丁大植 (1964-)|男|吉林省延吉市人|副教授|医学博士|主要从事心脏内分泌和心力衰竭的研究。
基金资助:
国家自然科学基金资助课题(30860091)

Evaluation of curative effect of meglumine cyclic adenylate combined with recombinant human brain natriuretic peptide in treatment of coronary artery disease patients with heart failure

DING Da-zhi^1,2,DING Jiang-shan³,JIN Zhen-yi¹,QIN Xiao-zhi¹,GUAN Li-ke¹,CUI Xun²

1. Department of Cardiology,Yanbian University Hospital,Yanji 133000, China;2. Key Laboratory of Natural Resources of Changbai Mountain &|Functional Molecules| Ministry of Education|Yanbian University,Yanji 133000,China;3.Department of Cardiology,Hospital of 3305 Factory,Dunhua 133709,China

Received:2011-03-22 Online:2011-07-28 Published:2011-07-28

摘要/Abstract

摘要：

目的：观察环磷腺苷葡甲胺（MCA）联合重组人脑利钠肽（rhBNP）治疗冠心病心力衰竭（心衰）患者的临床疗效及血流动力学和血浆BNP浓度的变化。方法：将54例心功能（NYHA） Ⅲ-Ⅳ级的冠心病患者随机分为3组，每组各18例。Ⅰ组用常规治疗，Ⅱ组用常规治疗+ MCA，Ⅲ组用常规治疗+ MCA + rhBNP。结果：① 临床疗效，Ⅰ组、Ⅱ组及Ⅲ组的总有效率分别为61.1%、77.8%和88.9%；Ⅱ和Ⅲ组的总有效率均优于Ⅰ组，且Ⅲ组的总有效率明显优于Ⅰ组（P<0.05）。② 血流动力学变化，3组治疗后每搏输出量（SV）、心输出量（CO）、心脏作功指数（CⅠ）、左室射血分数（LVEF）均升高，但以Ⅱ、Ⅲ组升高显著（均P<0.01）；与Ⅱ组比较，Ⅲ组明显升高（P<0.05,P<0.01）。治疗后Ⅱ、Ⅲ组二尖瓣血流舒张早期最大流速与心房收缩期最大流速的比值（E/A）均明显升高（均P<0.01）；与Ⅱ组比较，Ⅲ组明显升高（P<0.05）。③ 血浆BNP浓度的变化，3组治疗后BNP浓度均降低，但以Ⅱ、Ⅲ组降低显著（P<0.01,P<0.001）；与Ⅱ组比较，Ⅲ组明显降低（P<0.01）。结论：MCA 联合rhBNP治疗冠心病心衰有效、安全，两者具有协同作用。

关键词: 环磷腺苷葡甲胺；重组人脑利钠肽；脑利钠肽；心力衰竭；血流动力学

Abstract:

Objective To investigate the curative effect of meglumine cyclic adenylate(MCA) combined with recombinant human brain natriuretic peptide(rhBNP) in treatment of coronary artery disease patients with heart failure,and the changes of hemodynamics and the BNP concentration. Methods Fifty-four patients with coronary atherosclerotic heart disease whose heart function was Ⅲ-Ⅳ grade were divided into three groups(n=18):groupⅠ,conventional therapy;group Ⅱ:conventional therapy plus MCA;group Ⅲ,conventional therapy plus MCA combined with rhBNP. Results ① Clinical curative effect:the total effective rates of group Ⅱ(77.8%) and group Ⅲ(88.9%) were higher than that of group Ⅰ(61.1%), but the total effectively rate of group Ⅲ was obviously higher than that of groupⅠ(P<0.05). ② The changes of hemodynamics:after treatment,the stroke volume (SV),cardiac output (CO),cardiac index (CI) and left ventricle ejection fraction (LVEF) were increased in groupⅠ,Ⅱ,Ⅲ;they were significanthy increased in groupⅡ and group Ⅲ(P<0.01);compared with group Ⅱ,they were significanthy increased in group Ⅲ(P<0.05,P<0.01). The ratios of the peak flow rate of bicuspid blood current diastolic phase to atrial systole period (E/A) in group Ⅱand group Ⅲ were increased(P<0.01);compared with group Ⅱ,the E/A in group Ⅲ was significanthy increased (P<0.05). ③ The changes of BNP concentration:after treatment,the BNP concentrations were decreased in three groups,especially in group Ⅱ(P<0.01) and group Ⅲ(P<0.001);compared with groupⅡ,it was significant decreased in group Ⅲ(P<0.01). Conclusion MCAcombined with rhBNP has utility,safety and synergistic effect in treatment of coronary artery disease patients with heart failure.

Key words: meglumine cyclic adenylate;recombinant human brain natriuretic peptide;brain natriuretic peptide;heart failure;hemodynamics

中图分类号:

R541.6

丁大植,丁江山,金振一,秦孝智,关立克,崔勋. 环磷腺苷葡甲胺联合重组人脑利钠肽治疗冠心病心衰疗效评价[J]. J4, 2011, 37(4): 723-726.

DING Da-zhi,DING Jiang-shan,JIN Zhen-yi,QIN Xiao-zhi,GUAN Li-ke,CUI Xun. Evaluation of curative effect of meglumine cyclic adenylate combined with recombinant human brain natriuretic peptide in treatment of coronary artery disease patients with heart failure[J]. J4, 2011, 37(4): 723-726.