Therapeutic Effect of Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan on Senile Acute Anterior Myocardial Infarction with Decompensated Heart Failure in the Elderly and Its Influence on Serum NT-proBNP and Copeptin Levels
Abstract:Objective: To analyze the therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in the treatment of senile acute anterior myocardial infarction with decompensated heart failure in the elderly and its influence on serum levels of NT-proBNP and Copeptin. Methods: Totally 151 elderly patients with acute anterior myocardial infarction and decompensated heart failure admitted in our hospital from September 2017 to March 2021 were randomly divided into the combination group (n=76) and the control group (n=75). Both groups were treated with levosimendan on the basis of routine anti-ischemia and anti-heart failure treatment, and the combined group was treated with rhBNP additionally. The treatment effect, adverse reactions, changes of serum NT-proBNP and Copeptin were compared between the combination group and the control group, and the clinical value of the combined treatment regimen was analyzed. Results: The left ventricular ejection fraction (LVEF), cardiac output (CO), cardiac index (CI) and peripheral vascular resistance index (SVRI) of both groups were higher after 3 days of treatment then before treatment, and the increase range of combination group was higher than that of control group with statistically significant difference(P<0.05). Three days after treatment, the total effective rate of the combination group was 88.16%, which was higher than the control group at 65.33% with statistically significant difference(P<0.05). The incidence rate of adverse reactions in combination group and control group during treatment was 5.26% and 5.33%, respectively, and there was no significant difference between groups(P>0.05). The levels of serum NT-proBNP and Copeptin in both groups decreased after 3 days of treatment, and the decrease range of combination group was higher than that of control group with statistically significant difference(P<0.05). Conclusion: On the basis of standardized treatment and levosimendan, rhBNP can further improve the cardiac function of elderly patients with acute anterior myocardial infarction and decompensated heart failure, reduce the levels of NT-proBNP and Copeptin, and improve the clinical treatment effect, with good safety.
刘玉彬, 廖春梅, 庄燕妮, 谢周妮, 李陈, 肖灵芝. 重组人脑利钠肽联合左西孟旦治疗老年急性前壁心梗伴失代偿性心衰疗效及对血清NT-proBNP Copeptin水平的影响[J]. 河北医学, 2022, 28(3): 498-503.
LIU Yubin, LIAO Chunmei, ZHUANG Yanni, et al. Therapeutic Effect of Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan on Senile Acute Anterior Myocardial Infarction with Decompensated Heart Failure in the Elderly and Its Influence on Serum NT-proBNP and Copeptin Levels. HeBei Med, 2022, 28(3): 498-503.
[1] Fang J,Zeng W.A meta-analysis of the clinical efficacy of rhBNP in treating patients with acute myocardial infarction and heart failure[J].American Journal of Translational Research,2021,13(4):2410. [2] 李柏林,邹育明,梁明俊,等.重组人脑利钠肽联合托伐普坦治疗青中年急性心肌梗死合并心力衰竭的临床观察[J].广东医科大学学报,2018,36(6):660~663. [3] He X M,Chen L,Luo J B,et al.Effects of rhBNP after PCI on non-invasive hemodynamic in acute myocardial infarction patients with left heart failure[J].Asian Pacific Journal of Tropical Medicine,2019,9(8):769~773. [4] Cheng Y,Yang G,Tang Y,et al.Effect of recombinant human brain natriuretic peptide on myocardial enzymes and cardiac function after percutaneous coronary intervention in patients with acute myocardial infarction[J].Tropical Journal of Pharmaceutical Research,2019,18(1):123~127. [5] Wang L,Xie L,Wei X,et al.Beneficial effects of early administration of recombinant human B-type natriuretic peptide in ST-elevation myocardial infarction patients receiving percutaneous coronary intervention treatment[J].Singapore medical journal,2019,60(12):621. [6] Peng Y,Wei H.Role of recombinant human brain natriuretic peptide combined with sodium nitroprusside in improving quality of life and cardiac function in patients with acute heart failure[J].Experimental and therapeutic medicine,2020,20(1):261~268. [7] Li N,Gao X,Wang W,et al.Protective effects of recombinant human brain natriuretic peptide on the myocardial injury induced by acute carbon monoxide poisoning[J].Cardiovascular Diagnosis and Therapy,2020,10(6):1785. [8] Liang L,Tang R,Xie Q,et al.The clinical effect of recombinant human brain natriuretic peptide on asymptomatic peri-procedural myocardial injury after percutaneous transluminal coronary angioplasty[J].Scientific Reports,2020,10(1):1~7. [9] Zhang C,Pan S,Aisha A,et al.Recombinant human brain natriuretic peptide regulates PI3K/AKT/mTOR pathway through lncRNA EGOT to attenuate hypoxia-induced injury in H9c2 cardiomyocytes[J].Biochemical and Biophysical Research Communications,2018,503(3):1186~1193. [10] Xu Y,Li Y,Bao W,et al.Protective effects of recombinant human brain natriuretic peptide in perioperative period during open heart surgery[J].Experimental and Therapeutic Medicine,2018,15(3):2869~2873. [11] 陶智军.重组人脑利钠肽联合左西孟旦对急性心肌梗死合并心力衰竭的治疗价值研究[J].中国社区医师,2018,34(11):54~55. [12] 陈雄威.阿托伐他汀联合冻干重组人脑利钠肽治疗急性心肌梗死合并心力衰竭患者的临床疗效研究[J].心血管病防治知识,2021,11(5):30~32.