Clinical efficacy of recombinant human brain natriuretic peptide combined with non-invasive positive pressure mechanical ventilation in patients with severe heart failure
GUO Xiao-liang
LI Jun-yan
YUAN Yu
HUANG Guo-tao
DUAN Chang-en
ZHOU Chao-yuan
Abstract：Objective To investigate the clinical efficacy of recombinant human brain natriuretic peptide(rhB-NP)combined with non-invasive positive pressure ventilation(NIPPV)in treating patients with severe heart failure in the coronary care unit(CCU).Methods A retrospective analysis was performed on 159 patients with severe heart fail-ure admitted to the CCU from July 2020 to February 2023.After excluding 34 patients with incomplete data,125 patients were included in the study.They were divided into a control group(61 patients,receiving standard treatment+NIPPV)and an observation group(64 patients,receiving standard treatment+NIPPV+rhBNP).Clinical efficacy,cardiovas-cular disease indicators[endothelin-1(ET-1),galectin-3(Gal-3),brain natriuretic peptide(BNP)],cardiac function indicators[left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)],blood gas analysis[arterial oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2)],oxidative stress[malondialdehyde(MDA),serum cholinesterase(CHE),and su-peroxide dismutase(SOD)],quality of life and walking ability[Spitzer Quality of Life Index(SQLI),6-minute walk test,Kansas City Cardiomyopathy Questionnaire(KCCQ)],adverse reactions,and perioperative indicators were com-pared between groups.Results The total effective rate in the observation group was significantly higher than in the con-trol group(P＜0.05).Levels of ET-1,Gal-3,and BNP decreased in both groups,with a greater reduction in the ob-servation group(P＜0.05).The observation group had lower LVESV and LVEDV,and higher LVEF compared to the control group(P＜0.05).After treatment,PaO2 increased and PaCO2 decreased in both groups,with the observation group showing higher PaO2 and lower PaCO2(P＜0.05).CHE and SOD levels were higher in the observation group,while MDA levels were lower(P＜0.05).Quality of life scores(SQLI and KCCQ)and the 6-minute walk test results were better in the observation group(P＜0.05).The incidence of adverse reactions was similar between the two groups(P＞0.05).The observation group had a shorter CCU hospital stay and a lower overall incidence of adverse cardiac events(P＜0.05).Conclusion The combination of NIPPV and recombinant human brain natriuretic peptide provides better clinical outcomes for patients with ischemic cardiomyopathy and dilated cardiomyopathy in severe heart failure,ef-fectively alleviating symptoms,improving ET-1 and Gal-3 levels,and enhancing cardiac function.
Keywords：recombinant human brain natriuretic peptidenon-invasive positive pressure mechanical ventila-tionendothelin-1galactoside lectin 3clinical effect
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1361-1367 )