| Congestive heart failure is a cardiac in sufficiency, neuroendocrine activate peripheral blood flow anomaly distributing feature of complex clinical syndrome, is caused by the various causes of heart disease end marriage. Severe heart failure is heart medicine clinical common diseases, critical cases, frequently-occurring diseases, and a high mortality rate. Older patients because of its physiological characteristics, many viscera function decline, easy on diuretics, enlarge vascular drugs not sensitive to the drug digitalis class than other vulnerable to heart failure patients, such as the yankees to cause heart failure digitalis poisoning not correct. Therefore, elderly patients with heart failure have been intractable treatment of difficult work of cardiovascular disease. Although with the medical level unceasing progress, but heart failure caused by the mortality and didn't get the basic improvement. Brain natriuretic peptide (BNP), peptid brain natriuretic peptide is natriuretic peptide hormone, the kind with natriuretic, diuresis and the dilation of blood vessels, and the effect of RAS system, inhibit antagonism endothelin - I secrete. BNP plasma concentrations of close relations with left ventricular function for congestive heart failure diagnosis, treatment and prognosis of important value.objectiveThe purpose of this study was in conventional treatment for heart failure by the basis of human brain peptide (sodium application reorganization, new live element), and clinical efficacy was observed with traditional treatment compared to discuss new active element in the application of heart failure.Material and methodsAll cases from Ji Lin province in the people' s hospital heart medicine were four therapy area, in January 2009 to 2010 June meet the criteria for the elderly patients with 56 patients. In the Zhang Zhibin vol.48 book congestive heart failure the Framingham heart failure diagnosis to Boston standards and, according to New York heart association NYHA standard for cardiac grading. Using a randomized, divided into treatment group and control group. In standard of treatment group is the basis of traditional treatment for heart failure application restructuring the brain peptide (sodium element), new live application loading doses 1.5 ug/kg, maintenance dose for 0.01 ug/kg/min total 72 hours.All patients were hospital and was in three days,1 month after follow-up of patients, making BNP, LVEF,K+\Na+,and the concentration degree of clinical symptoms, and compare grading and cardiac function in serum before and after the treatment of endothelin concentration changes, thus evaluated new live element of heart failure role.Results calculationAll material are SPSS13.0 software, measuring data, said mean + standard deviation with compares the t-test, counting material adopts a chi-square test, P< 0.05 with tasseled learning significance.The results1,Treatment of three days, the treatment group 1345.28 BNP levels (plus or minus 485.26 pg/ml) obviously lower than admission standards (2863.22 + 865.34 pg/ml) P< 0.001, and obviously lower than the control group 1964.86 BNP levels (plus or minus 472.83 pg/ml) P< 0.05. A month later, the treatment group 1296.67 BNP levels (plus or minus 620.28 pg/ml) and treatment three days without opparent change, but still lower than those of the control group therapy (1903.79 + 898.87 pg/ml), and a statistically significant (P< 0.05).2,The treatment group and control group left ventricular ejection fraction (LVEF) were significantly higher. Treatment three days, the treatment group 38.57 + 6.69%) (LVEF significantly higher than those in the control group (34.89 + 5.87%), (P< 0.05). A month later, the treatment group LVEF (plus or minus 7.12%) obvious 43.78 than in control group (36.06 + 6.01%), (P< 0.05), with a statistical significance.3,As the treatment, the two groups of cardiac and clinical symptoms were all have different degrees of improvement. Three days, the treatment group,28 cases got in 10 cases, 16 cases of effective, invalid for 2 cases, total effectiveness is 92.86%; The control group, there are 5 cases and 14 cases were effective,< 9 cases is invalid, the total effective rate was 67.86%; Compare two sets of curative effect, the treatment group was better than control. A month later, the treatment group,15 cases of patients got effective,1 case is invalid, the total effective rate 96.43%; Eight cases of control group, and 14 cases were effective, got six cases failure; the total effective invalid 78.57%. The treatment group than in control group (P< 0.05), and a tasseled learning significance.4,Respectively on treatment before and after treatment 3 days, determination of plasma and making the concentration of K,Na+, the treatment group treatment of the blood (135.27±3.29)mmol/L with before treatment (143.08±5.02) mmol/L comparison, reduced significantly, and difference was statistically significant (P< 0.05), in addition to its blood K concentration obvious difference was statistically significant increased (P< 0.05). While the control group has no obvious changes before and after treatment.5,Respectively on treatment before and after treatment 24 hours and three days, determination of plasma ET-1 concentration. Results showed that the treatment group 24 hours ET-1 content (82.44±8.34) pg/ml, significantly lower before treatment, a statistically significant difference in treatment. In the placebo group were not significantly change before and after treatment6, In treatment process, we found out that the group only 1 cases adverse reactions, postural hypotension, and for symptoms in 30 minutes after discontinuation disappear.ConelusionRestructuring the brain sodium peptide (new living meat) in the treatment of senile severe congestive heart failure patients efficacy is obvious, the treatment effect is superior to the traditional drug therapy. Standard And high safety, fewer side effects. |
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