Clinical value of early application of nesiritide after cardiac valve surgery / 中国生化药物杂志

ABSTRACT

Objective To identify the protective effects of early application of nesiritide on myocardial injury and cardiac function after cardiac valve surgery.Metheds 78 patients with cardiac valve surgery in the hospital from November 2013 to February 2015 were randomly divided into nesiritide group(n=38) and control group(n=40).Nesiritide group received the routine treatment plus 24-72 hour treatment of nesiritide [0.01 ug/(kg · min)], and control group received only the routine treatment.Observation index①Cardiac troponin (cTnI) and MB isoenzyme of creatine kinase (CK-MB) venous blood was tested before and after operation 0h, 24 h and 72 h;②Serum creatinine (SCr) venous blood was tested before and after surgery 7 days;③Left ventricular ejection fraction ( LVEF) echocardiography was done before and after operation 7 days;④ICU residence time and mechanical ventilation time.Results There was no significant difference between two groups in cTnI and CK-MB at 24 hour after operation.However, at 72 hour after operation, cTnI in nesiritide group was(5.10 ±2.03)ng/mL, lower than that in control group[(8.94 ±3.35)ng/mL,P<0.05];CK-MB in nesiritide group was (23.24 ±14.67U/L), lower than that in control group[(36.27 ±12.18)U/L,P<0.05].There was no significant difference in SCr level between two groups after operation.At 7 day after operation, LVEF improved significantly in nesiritide group[(60.47 ±8.60)%] comparing with control group [(54.60 ±10.92)%] (P <0.05).There was no significant difference between the groups in ICU residence time.However, the mechanical ventilation time was significantly shorter in nesiritide group[(3.14 ±1.95)d] comparing with control group[(4.29 ±2.25)d](P<0.05). Conclusion Early application of nesiritide could alleviate myocardial injury and improve cardiac function after cardiac valve surgery.