Effect Of Intravenous RhBNP On Heart And Kidney Function In Patients With Acute Anterior Myocardial Infarction Combined With Diabetes Mellitus

Objective:To observe the changes of heart and kidney function at 24 h,72h and 7d after admission to hospital by using the recombinant human brain natriuretic peptide(rhBNP)of the patients with acute anterior myocardial infarction combined with diabetes mellitus,and to evaluate the effect of rhBNP on the heart and kidney function.Methods: A randomized,double-blind controlled trial was used in this study.The patients were randomly divided into recombinant human brain natriuretic peptide group(rhBNP group)and nitroglycerin group(NIT group).According to the test requirements,the patients of two groups were given corresponding medication.The baseline data,the changes of heart and kidney function before and after 24 h,72h and 7d of medication in the two groups were compared.The differences of main adverse cardiac events within 30 days of the two groups were compared.All data were analyzed by SPSS 21.0 software,and P<0.05 was defined as statistically significant.Results: 53 cases of patients were selected in this study,including 32 cases of male and 21 cases of female,25 cases in the rhBNP group(14 cases of male,mean age 60.24±7.05 years),and 28 cases in the NIT group(18 cases of male,mean age 58.89±6.81 years).There were no significant differences in the baseline data,the levels of SCr,CysC and eGFR between the two groups.The 24 hour urine volume of the patients in the two groups was significantly higher than that in the NIT group,and the difference was statistically significant.The 24 hour urine volume in the two groups was similar,and the difference was not statistically significant.The SCr value after 72 h and the CysC value after 24 h,72h of medication in the rhBNP group and the NIT group were significantly difference.The eGFR value at 24 h,72h,LVEF value and the E/e’value at 7d were statistically significant when compared with those at 24 h.The SCr value and CysC value at 24 h and 72 h of medication in the rhBNP group were higher than those of baseline,and the difference was statistically significant.The eGFR value at 24 h and 72 h decreased of the group,the difference was statistically significant;LVEF value at 7d was higher than that at 24 h,and the E/e’ value had no significant change when compared with that at 24 h,and the differences were statistically significant.The SCr value,CysC value and eGFR value of the NIT group at 24 h,72h and 7d had no significant difference compared with the baseline level,and the LVEF value and E/e’ value at 7d had no significant difference compared with those at 24 h.During the period of hospitalization,there were 2 cases of patients in the NIT group had headache;8 cases of patients in the NIT group,9 cases in the rhBNP group had hypotension,which could be restored to normal level after adjusting the dose of drug,and the hypotension in the two groups did not affect the hemodynamics;the two group had no anaphylaxis and malignant arrhythmia.After one month of follow-up,no MACEs occurred in both groups.Conclusion: Intravenous rhBNP can improve the heart function of patients with acute anterior myocardial infarction combined with diabetes mellitus,and may has an transient damage to the kidney function,but it can be recovered in the short term,which is safe and effective in general.