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目的对比研究硝普钠和重组人脑利钠肽(rh BNP)分别对急性心肌梗死(AMI)合并急性心力衰竭(AHF)的临床疗效。方法随机选择心功能三级并没有心源性休克、AMI并AHF的患者56例,随机分为A组(rh BNP组)和B组(硝普钠组),在静脉应用呋塞米针剂治疗心力衰竭和标准抗缺血治疗基础上,依次加用rh BNP和硝普钠,分别观察两组患者24小时液体出入量,72小时后左心室舒张末期内径(LVEDD)、血清脑钠肽(BNP)水平、左心室射血分数(LVEF)。结果 A组用药24小时后尿量及出入量差值明显高于B组,72小时后两组患者LVEDD及BNP水平均较前显著下降,LVEF均明显上升,但A组升高和降低的幅度均较B组高。结论相比硝普钠而言,rh BNP更能改善AMI合并AHF患者的血流动力学表现和临床症状,效果显著。
Objective To compare the clinical effects of sodium nitroprusside and recombinant rhBNP on patients with acute myocardial infarction (AMI) and acute heart failure (AHF). Methods Fifty-six patients with AMI and AHF were randomly divided into group A (rh BNP) and group B (sodium nitroprusside group), and received intravenous furosemide injection Heart failure and standard anti-ischemic treatment, followed by addition of rhBNP and sodium nitroprusside, respectively, two groups of patients with fluid intake and exit 24 hours, 72 hours after the left ventricular end-diastolic diameter (LVEDD), serum brain natriuretic peptide ) Level, left ventricular ejection fraction (LVEF). Results After 24 hours, the urine output and the difference between the two groups were significantly higher than those in group B. After 72 hours, the levels of LVEDD and BNP in both groups were significantly lower than those in group A and LVEF, but the amplitude of increase and decrease in group A Higher than the B group. Conclusion Compared with sodium nitroprusside, rh BNP can improve hemodynamics and clinical symptoms in AMI patients with AHF.