摘要
目的探究冻干重组人脑利钠肽(商品名:新活素)对体外循环下心脏瓣膜置换术患者早期预后的影响。方法52例择期行体外循环下心脏瓣膜置换术患者,采用随机抽签法分为对照组和观察组,每组26例。两组患者均顺利完成手术,对照组术后予以常规强心利尿、扩血管药物,观察组在对照组的基础上加用新活素。比较两组用药前、用药3 d后的肌钙蛋白T(cTnT)、脑钠肽(BNP)、肌酸激酶同工酶(CK-MB)水平,术后血管活性药物用量、机械通气时间、重症加强护理病房(ICU)停留时间,心脏不良事件发生情况。结果用药3 d后,两组的血清cTnT、CK-MB、BNP水平均低于本组用药前,且观察组的cTnT(0.11±0.05)μg/L、CK-MB(23.15±4.13)U/L、BNP(317.68±89.05)ng/L显著低于对照组的(0.33±0.14)μg/L、(29.47±7.10)U/L、(445.17±96.83)ng/L,差异具有统计学意义(P<0.05)。观察组术后血管活性药物用量(398.65±50.97)mg少于对照组的(437.46±67.48)mg,术后机械通气时间(25.88±2.75)h、术后ICU停留时间(2.73±0.67)d短于对照组的(31.38±4.78)h、(3.50±0.51)d,差异具有统计学意义(P<0.05)。观察组术后心脏不良事件发生率7.69%低于对照组的38.46%,差异具有统计学意义(P<0.05)。结论体外循环下心脏瓣膜置换术后应用新活素能够有效改善患者心功能,减轻心肌损伤,对于缩短术后康复进程和改善早期预后具有重要的意义。
Objective To investigate the effect of lyophilized recombinant human brain natriuretic peptide(trade name:Xinhuosu)on early prognosis of patients undergoing cardiac valve replacement under cardiopulmonary bypass.Methods A total of 52 patients undergoing elective cardiac valve replacement under extracorporeal circulation were divided into a control group and an observation group according to the random lottery method,with 26 cases in each group.Patients in both groups completed the surgery successfully,and the control group was given conventional cardiotonic diuretic and vasodilator drugs after the surgery,while the observation group was given Xinhuosu on the basis of the control group.Both groups were compared in terms of levels of cardiac troponin T(cTnT),brain natriuretic peptide(BNP),creatine kinase isoenzyme(CK-MB),postoperative vasoactive drug dosage before medication and after 3 d of medication,duration of mechanical ventilation,intensive care unit(ICU)stay,and occurrence of cardiac adverse events.Results After 3 d of medication,the serum cTnT,CK-MB,and BNP levels in both groups were lower than those before medication in this group;the observation group had cTnT of(0.11±0.05)μg/L,CK-MB of(23.15±4.13)U/L,and BNP of(317.68±89.05)ng/L,which were significantly lower than those of(0.33±0.14)μg/L,(29.47±7.10)U/L,and(445.17±96.83)ng/L in the control group;the differences were statistically significant(P<0.05).The postoperative vasoactive drug dosage of(398.65±50.97)mg in the observation group was less than that of(437.46±67.48)mg in the control group;the duration of postoperative mechanical ventilation of(25.88±2.75)h and postoperative ICU stay of(2.73±0.67)d in the observation group were shorter than those of(31.38±4.78)h and(3.50±0.51)d in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative cardiac adverse events in the observation group was 7.69%,which was lower than that of 38.46%in the control group,and the difference was statistically significant(P<0.05).Conclusion Application of Xinhuosu after cardiac valve replacement under cardiopulmonary bypass can effectively improve cardiac function and reduce myocardial injury,which is of great significance to shorten the postoperative rehabilitation process and improve the early prognosis.
作者
卜林
BU Lin(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国实用医药》
2023年第8期13-16,共4页
China Practical Medicine
关键词
体外循环
心脏瓣膜置换术
冻干重组人脑利钠肽
早期预后
Cardiopulmonary bypass
Cardiac valve replacement
Lyophilized recombinant human brain natriuretic peptide
Early prognosis
