ABSTRACT
Objective To observe the clinical effect of Levosimendan for treatment of patients with refractory heart failure in order to provide a reference for doctors treating this disease. Methods One hundred and eighty patients with refractory heart failure were admitted to Tongde Hospital of Zhejiang Province from February 2014 to December 2017, and they were divided into two groups by random number table method: a western medicine routine treatment group (western control group) and a Levosimendan group, each group 90 cases. The patients in western control group were given conventional anti-cardiac failure drugs ; and those in Levosimendan group were treated with the therapies as above group, and additionally Levosimendan continuous intravenous infusion for 24 hours was given. The clinical efficacy of the two groups was evaluated after 3 days of treatment. After treatment, the differences of ejection fraction (EF), stroke volume (SV), end-systolic volume (ESV), end-diastolic volume (EDV) and the levels of N-terminal brain natriuretic peptide precursor (NT-proBNP) and cardiac troponin I (cTnI) were compared between the two groups. Results After treatment, the EF and SV levels were significantly increased, while the ESV, EDV, NT-proBNP and cTnI levels were decreased obviously compared with those before treatment in the two groups (all P <0.05); the changes of the levels of EF, SV and NT-proBNP and cTnI of Levosimendan group were more significant than those of the western control group [EF: 0.49±0.06 vs. 0.44±0.06, SV (mL): 86.54±17.63 vs. 81.48±18.46, NT-proBNP (μg/L): 5.50±1.28 vs. 6.64±1.54, cTnI (μg/L): 0.08±0.01 vs. 0.14±0.13, all P < 0.05], while there were no significant differences of the levels of ESV and EDV between the two groups [ESV (mL): 111.56±32.53 vs. 128.76±32.13, EDV (mL): 187.95±39.28 vs. 185.06±41.23, both P > 0.05]. The total effective rate of the Levosimendan group was obviously higher than that of the western control group [97.78% (88/90) vs. 78.89% (71/90), P < 0.05]. Conclusion Levosimendan can effectively improve the hemodynamics in patients with refractory heart failure, the elevation of patients' heart function, and the short-term therapeutic effect is very remarkable.
ABSTRACT
Objective To explore the hypersensitive c‐reactive protein(hs‐CRP) combined N‐brain natriuretic peptide precursor application value in heart failure .Methods 50 cases of heart failure patients of our hospital as research object ,this group of patients as experimental group .In order to make the research more persuasive ,in addition to select 50 cases of healthy people as control group .Experimental group patients to standards as set by the u .s .New York heart association ,according to the grouping of 24 pa‐tients with rank Ⅱ ,Ⅲ level 15 patients ,11 patients with Ⅳ level .Using colloidal gold method of N‐terminal patients plasma brain natriuretic peptide precursor concentration and left ventricular ejection fraction ,the concentrations of plasma brain natriuretic pep‐tide precursor N‐end needs were determined and the concentration of the hospital for five days prior to admission .Measurement by scattering turbidimetry ,and also need the hs‐CRP serum levels .Results Compare two groups of measuring results were found that the experimental group than the control group of N‐the brain natriuretic peptide precursor level obviously higher ,and the left ven‐tricular ejection fraction was lower than the control group .For the hs‐CRP serum levels of the experimental group is significantly higher than the control group ,cardiac function classification as the increasing of the number of this gap is widening .At levels Ⅱ -Ⅳ obvious the differences between the three ,with statistical significance(P<0 .05) .Conclusion hs‐CRP and N‐brain natriuretic peptide precursor concentration can be as an important indicator of heart failure determination ,has united both in clinical can more effectively to diagnosis heart failure .hs‐CRP in combination with N‐terminal brain natriuretic peptide precursor obvious effects of application in heart failure ,is worth popularizing in clinical use .
ABSTRACT
Objective To investigate the healthy adults in Heyuan area of serum N terminal pro brain natriuretic peptide (N‐proBNP) concentration distribution and the preliminary investigation on the normal reference range .Methods From 2010 Novem‐ber to 2012 November in the physical examination ,laboratory examination center of our hospital indicators ,ECG ,B ultrasound ex‐amination showed no abnormalities of the healthy people 1 017 ,according to the different gender and age :A group less than 25 years ,group B was 25- <35 years ,35- <45 years ,group C ,group D 45- <55 years ,55- <65 years of E group ,F group for over 65 years a total of 6 age groups ,content determination of serum N‐proBNP by Roche chemical instrument light .Results age ,gen‐der can affect the distribution of N‐proBNP level ,and with the increase of age ,adjacent to the age groups (except F group) to com‐pare the serum levels of N‐proBNP ,the difference was statistically significant (P<0 .05);Compared with the F group in each age group was significantly increased(P<0 .05) ,there was statistical significance compared with the group ;the serum N‐proBNP level of different sex ,the difference was statistically significant (P<0 .05) .Conclusion age ,gender and other physiological factors can affect the distribution of N‐proBNP levels ,should establish the corresponding reference interval according to the different age ,gen‐der ,provide the corresponding parameters for the diagnosis and treatment of related diseases .
ABSTRACT
Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.