Clinical Effects Of Recombinant Human Brain Natriuretic Peptide On Patients With Acute Myocardial Infarction In Combination With Heart Failure And Observation On Prognosis

Objective:To evaluate the effect of routine treatment combined with recombinant human brain natriuretic peptide(rhBNP)in patients with acute myocardial infarction and heart failure,and observe the prognosis of patients.Methods:92 patients with acute myocardial infarction complicated with heart failure were randomly divided into control group(48 cases)and rhBNP group(44 cases).The patients in the control group were treated with routine drugs,while the patients in the rhBNP group were treated with routine drugs and recombinant human brain natriuretic peptide at a concentration of 0.0075-0.015 ug/kg/min by intravenous micro pumping for 5 days.The improvement of symptoms and signs of heart failure was compared between the two groups.Analyze the changes of heart rate,systolic blood pressure(SBP)and diastolic blood pressure(DBP),urine volume and N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble ST2(sST2)and alanine aminotransferasre(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),serum creatinine(sCr),creatinine clearance rate(cCr),blood sodium(Na~+),blood potassium(K~+).The changes of left ventricular ejection(LVEF),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)in the two groups before and after treatment and after 3 months,6months and 12 months of follow-up were compared.The incidence of major adverse cardiac events,such as angina pectoris,re-admission of heart failure and all-cause death,were calculated.Results:1.After treatment,the total effective rate of improving clinical symptoms and signs in the rhBNP group was higher than control group(P<0.05).2.The heart rate of rhBNP group was lower than that of the control group(P<0.05).The levels of SBP and DBP in the two groups were decreased,but there was no significant difference between the two groups(P>0.05).The 24-hour urine volume of the patients was increased compared with that before treatment,and the rhBNP group was significantly better than the control group(P<0.05).3.The concentrations of NT-proBNP and sST2 were decreased in both groups after treatment,and the decrease in rhBNP group was more significant than that in the control group(P<0.05).4.Compared with the control group,the level of cCr in the rhBNP group was significantly increased after treatment(P<0.05).Compared with before treatment,the ALT,AST and Na~+,K~+did not change significantly after treatment(P>0.05).5.Compared with the control group,the LVEF of the rhBNP group were increased(P<0.05),and the LVEDV and LVESV were decreased(P<0.05).After 3 months,6months and 12 months of follow-up,the LVEF values of the rhBNP group were higher than those of the control group(P<0.05),and the LVEDV and LVESV values were lower than the control group(P<0.05).6.The angina pectoris rates,re-admission rates and major adverse cardiac events incidence in the rhBNP group were lower than those in the control group(P<0.05).There was no significant difference in all-cause mortality rates(P>0.05).Conclusion:In the early stage,actively combined with recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicated with heart failure,on the one hand,it can quickly improve the patient’s dyspnea,lung vocalization and edema and other clinical symptoms and signs.It is important to effectively suppress ventricular remodeling,and has reliable drug safety in clinical applications.