| Objective:Late stages of various heart diseases can progress to heart failure.In our clinical work,elderly patients have a higher proportion of acute onset of chronic heart failure(CHF)hospitalization.Previously,diuretics,ACEI,ARB,beta blockers,digitalis drugs,aldosterone were used.Body antagonists are also unsatisfactory for elderly patients with chronic heart failure.Xinmailong injection is a drug used in the treatment of heart failure in recent years,and has achieved good results,and has fewer adverse reactions,is safer and more reliable,and provides new treatment options for many patients with heart failure.This study was conducted to observe the effect of Xinmailong injection on elderly patients with chronic heart failure and the related factors of cardiac function such as left ventricular end-diastolic diameter,left ventricular ejection fraction and NT-proBNP.The clinical efficacy of chronic heart failure and its impact on the hospitalization rate and mortality of patients,analysis of its clinical value,provide a basis for clinical drug use in patients with chronic heart failure.Methods:This study retrospectively analyzed 390 patients with chronic heart failure in New York patients with grade III-IV from September 2016 to September 2018 in our hospital cadre ward.The treatment was interrupted due to allergies,the medication was not adequate,and the data were not reviewed on time.A total of 165 patients with incomplete disease,a total of 225 patients,including 135 males and 90 females,with an average age of 87.12±4.05 years old.There were 90 cases in the Xinmailong group,63 cases in the recombinant human brain natriuretic peptide(rhBNP)group and 72 cases in the control group.The control group was given standardized treatment according to the heart failure guidelines(diuretic,angiotensin-converting enzyme inhibition/angiotensin II receptor antagonist,beta blocker,digitalis),Xinmailong group plus Xinmailong injection 300 mg + 0.9% sodium chloride injection 50 ml for 3 hours on the basis of standardized treatment Intravenous infusion,2 times a day,2 times interval > 6h,1 week of treatment,the rhBNP group added lyophilized recombinant human brain natriuretic peptide(rhBNP)on the basis of standardized treatment,the first dose load 1.5 ug/kg,continuous intravenous infusion of 0.075ug·kg·min intravenous bolus for 24 h after intravenous bolus injection,continuous application for 1 week,review the relevant indicators after 1 week.Three groups of patients with post-treatment cardiac function,N-terminal pro-b-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular diastolic The improvement of the left ventricular end diastolic diameter(LVEDD)was followed up for 6 months.The rehospitalization rate and mortality rate of patients with heart failure were counted.The data were analyzed by SPSS21.0 statistical software.The count data was described by the number of cases n(%).The difference between groups was tested by Chi-square test;the measurement data were described by mean ± standard deviation(x ± s).The comparison was analyzed by variance F test.The paired sample t test was used before and after treatment in the group.The difference was statistically significant at P<0.05.Results:1.After 1 week of treatment,the effective rate of Xinmailong group was 71.1%,the effective rate of rhBNP group was 74.6%,and the effective rate of control group was 52.8%.The difference of effective rate was statistically significant(p<0.05),and the effective rate of Xinmailong was better than that of control group.In the group,the effective rate of rhBNP group was larger than that of control group,and there was no statistical difference between the Xinmailong group and the rhBNP group,and no obvious adverse reactions were observed.2.The differences of LVEF in the Xinmailong group,rhBNP group and control group were statistically significant(P<0.05).the LVEDD was not statistically significant.The left ventricular end-diastolic diameter after treatment in Xinmailong group and rhBNP group,Compared with the control group,the left ventricular ejection fraction and NT-proBNP decreased by ? 30% were statistically significant(P<0.05).The improvement was higher than that of the control group,but there was no significant difference between the Xinmailong group and the rhBNP group(P>0.05).The LVEDD was not statistically significant.3.In the Xinmailong group,11 patients(12.22%)were hospitalized due to heart failure within 6 months,8 patients(12.70%)in the rhBNP group,20 patients(27.78%)in the control group,and 9 patients died in the Xinmailong group due to heart failure,5 cases(7.94%)in the rhBNP group and 8 cases(11.11%)in the control group.The incidence of re-hospitalization due to heart failure: Xinmailong group and rhBNP group were lower than the control group(P<0.05).However,there was no significant difference between Xinmailong group and rhBNP group(P>0.05).The incidence of death due to heart failure was compared: the rhBNP group was lower than the control group(P<0.05),and there was no significant difference between the Xinmailong group and the control group(P>0.05).Conclusion:1.Xinmailong can improve the symptoms and signs of elderly patients with acute heart failure and is significantly better than the control group,which is equivalent to the rhBNP group;2.After one week of treatment with Xinmailong,the left ventricular ejection fraction of elderly patients with acute onset of chronic heart failure can be improved and NT-proBNP can be reduced.There is no significant difference with rhBNP and there is no serious adverse reactions;3.Xinmailong can reduce the rehospitalization rate of heart failure in elderly patients with chronic heart failure within 6 months,which can be used as a treatment option for chronic heart failure;4.Xinmailong is economical and low cost-effective,which can be used in clinical promotion. |
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