| Objective: To observe the efficacy assessment and the effect on cardiac function after early application of recombinant human brain natriuretic peptide in patients with acute anterior wall myocardial infarction admitted to our hospital for emergency PCI.Methods: One hundred and ten patients with acute anterior wall myocardial infarction admitted to the 920 th Hospital of the People’s Liberation Army Joint Security Force from June 2019 to December 2022,with recombinant human brain natriuretic peptide drug approved into our hospital in June 2020,were retrospectively selected as the cut-off.The patients were divided according to their treatment into a conventional treatment group(n=55)and a recombinant human brain natriuretic peptide group(recombinant human brain natriuretic peptide treatment on top of conventional treatment,n=55).Vital signs(heart rate,systolic blood pressure,diastolic blood pressure)at admission,24 hours after emergency PCI and on the 7th day of treatment,evaluation of efficacy after 1 week of treatment,occurrence of adverse effects,admission and follow-up cardiac ultrasound(including cardiac output(CO),stroke volume(SV),left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD))were statistically analysed in both groups.The data obtained were analysed statistically using SPSS 26.0 software.Results:1.Comparison between the two groups before and after treatment:(1)The heart rate,diastolic blood pressure and systolic blood pressure of patients in the recombinant human brain natriuretic peptide group were significantly lower 24 hours after emergency PCI treatment compared with those before treatment(P < 0.05).The heart rate,diastolic blood pressure and systolic blood pressure on the 7th day of treatment were significantly lower than those before treatment(P < 0.05).(2)The heart rate,diastolic blood pressure and systolic blood pressure of patients in the conventional treatment group were all significantly lower 24 hours after emergency PCI compared with those before treatment(P < 0.05).The heart rate,diastolic blood pressure and systolic blood pressure on the 7th day of treatment were all significantly lower than those before treatment(P < 0.05).(3)The results of cardiac ultrasound before treatment and 1 month after discharge in the recombinant human brain natriuretic peptide group showed no significant changes in cardiac output(CO)and left ventricular end diastolic internal diameter(LVEDD)(P > 0.05),and significant improvements in output per beat(SV)and left ventricular ejection fraction(LVEF)(P< 0.05).(4)The results of cardiac ultrasound before treatment and after discharge in the conventional treatment group indicated that there was no significant change in CO and SV(P > 0.05),improvement in left ventricular ejection fraction(LVEF)and enlargement of left ventricular end diastolic internal diameter(LVEDD)(P < 0.05)compared with those before.2.Comparison between the two groups:(1)Gender,age,killip classification,history of hypertension,history of smoking and history of diabetes mellitus in patients in the recombinant human brain natriuretic peptide group and conventional treatment group before treatment.The differences in general information between the two groups were not significant(P > 0.05).(2)The differences in heart rate,diastolic blood pressure and systolic blood pressure between the recombinant human brain natriuretic peptide group and the conventional treatment group were not significant(P > 0.05)before treatment,24 hours after emergency PCI and on the 7th day of treatment.(3)There were no significant differences in CO,SV,LVEF,LVEDD between recombinant human brain natriuretic peptide group and conventional treatment group(P > 0.05).Reexamination of cardiac color ultrasound 1 month after discharge between the recombinant human brain natriuretic peptide group and the conventional treatment group indicated that there was no significant difference in CO between the two groups(P > 0.05).The increases of SV and LVEF in recombinant human brain natriuretic peptide group were significantly higher than those in conventional treatment group(P < 0.05).The LVEDD in conventional treatment group was significantly enlarged compared with that in recombinant human natriuretic peptide group(P < 0.05).(4)The total effective rate in the recombinant human brain natriuretic peptide group was 98.2%(54/55),compared with 94.5%(52/55)in the conventional treatment group,and the efficacy of the recombinant human brain natriuretic peptide group was higher than that of the conventional treatment group(P < 0.05).(5)There was no significant difference in the incidence of adverse reactions of recurrent heart failure,malignant arrhythmia and hypotension between the two groups(P > 0.05).Conclusions:(1)For patients diagnosed with acute anterior myocardial infarction,early application of recombinant human brain natriuretic peptide after PCI can effectively relieve symptoms of heart failure in a short time.(2)For patients diagnosed with acute anterior myocardial infarction,early application of recombinant human brain natriuretic peptide after emergency PCI can inhibit ventricular remodeling and contribute to the recovery of left cardiac function in the short term.(3)For patients diagnosed with acute anterior myocardial infarction,early application of recombinant human brain natriuretic peptide after PCI on admission to emergency has no obvious adverse effects,and is safe and reliable. |
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