Abstract：Objective: To investigate the efficacy of topaplatin combined with nesiritide in the treatment of acute heart failure (AHF) and its effect on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), troponin T (cTnT) and soluble ST2 (sST2). Methods: 200 patients with AHF were randomly divided into the control group (n = 100, nesiritide) and the observation group (n = 100, tovapritide + nesiritide) according to the method of residues of random number table. The clinical efficacy, ventricular remodeling, serum NT-proBNP, cTnT, sST2 expression and safety were compared between the two groups. Results: The total effective rate of the observation group was 93.00%, which was higher than that of the control group (82.00%) (P<0.05). The changes of left ventricular end-systolic volume index (LVESVI), left ventricular end-diastolic volume index (LVEDVI) and left ventricular mass index (LVMI) in the observation group were significantly higher than those in the control group before and after treatment. The changes of serum NT-proBNP, cTnT and sST2 levels in the observation group before and after treatment were significantly higher than those in the control group (P<0.05). The incidence of adverse reactions in the observation group was 6.00%, which was lower than that in the control group (15.00%) (P<0.05). Conclusion: Tovaptan combined with nesiritide is superior to nesiritide in the treatment of AHF. It can not only delay ventricular remodeling, but also reduce the expression of serum NT-proBNP, cTnT and sST2 and reduce the incidence of adverse reactions.
孙维, 菅志飞, 张继勇. 托伐普坦联合奈西立肽治疗急性心力衰竭的疗效及对NT-proBNP cTnT sST2水平的影响[J]. 河北医学, 2021, 27(5): 873-877.
SUN Wei, JIAN Zhifei, et al. Efficacy of Tolvastan Combined with Nesiritide in the Treatment of Acute Heart Failure and Its Effect on The Levels of NT-proBNP cTnT and sST2. HeBei Med, 2021, 27(5): 873-877.
[1] 王艳飞,解俊敏,董斌,等.急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术后发生急性心力衰竭的临床特点[J].中国老年学杂志,2018,38(2):324~325. [2] Chun K H,Kang S M.Is risk stratification with the larissa heart failure risk score useful in japanese acute heart failure patients[J].International Journal of Cardiology,2020,307:125~126. [3] B A N P A,C W N S M A.BNP-response to acute heart failure treatment identifies high-risk population[J].Heart,Lung and Circulation,2020,29(3):354~360. [4] 徐亚妹,周京敏.2019 ESC心力衰竭协会充血性心力衰竭利尿剂使用声明解读[J].中国循环杂志,2019,34(S1):73~75. [5] 黄峻.急性心力衰竭诊断和治疗指南要点[J].中国社区医师,2010,27(27):9. [6] 屈宇.利尿剂在心力衰竭中的治疗价值分析[J].世界最新医学信息文摘,2019,19(25):119~120. [7] Niikura H,Iijima R,Anzai H,et al.Clinical utility of early use of tolvaptan in very elderly patients with acute decompensated heart failure[J].Anatol Cardiol,2017,18(3):206~212. [8] 潘博,田杰.心脏舒张功能障碍的基础与临床研究进展[J].中华实用儿科临床杂志,2018,33(13):961~965. [9] 马作旺,张凯,王卫定,等.托伐普坦通过调控微小RNA 21改善大鼠心房重构[J].中华心血管病杂志,2019,47(8):614~621. [10] 王德兴,王琳,范张欣.急性心肌梗死患者前白蛋白、脑钠肽、心肌肌钙蛋白T、肌酸激酶同工酶与短期预后的关系[J].中国循证心血管医学杂志,2017,9(12):1507~1512. [11] Wang E W,Jia X S,Ruan C W,et al.miR-487b mitigates chronic heart failure through inhibition of the IL-33/ST2 signaling pathway[J].Oncotarget,2017,8(31):51688~51702. [12] 肖幸,李珊珊,凃玲,等.托伐普坦治疗老年心力衰竭的回顾性研究[J].中国医院药学杂志,2019,39(18):66~68.
2021, Vol. 27 
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