Guoji laonian yixue zazhi (Mar 2024)
Comparison of Different Doses of Recombinant Human Brain Natriuretic PeptideCombined with Bisoprolol in Elderly Patients with Acute Myocardial Infarction after PCI
Abstract
Objective To compare the value of different doses of recombinant human brain natriuretic peptide(rhBNP) combined with bisoprolol after percutaneous coronary intervention(PCI) in elderly patients with acute myocardial infarction(AMI). Methods A total of 138 elderly patients with AMI in First Hospital of Qinhuangdao from January 2020 to October 2022 were prospectively selected, they were divided into 3 groups with 46 cases in each group by random number table.All groups were treated with PCI and bisoprolol, 2 hours before surgery, the low-dose group received 1.5 μg/(kg·min) rhBNP, the medium-dose group received 2.0 μg/(kg·min) rhBNP, and the high-dose group received 3.0 μg/(kg·min) rhBNP.Cardiac function [left ventricular ejection fraction(LVEF), cardiac index(CI), stroke volume per minute(SV), plasma brain natriuretic peptide(BNP)] , electrocardiographic parameters [standard diviation of NN intervals(SDNN), root mean square of successive RR interval differences(RMSSD), low frequency band/high frequency band(LF/HF)] , renal function [serum creatinine(Scr), β2-microglobulin(β2-MG), blood urea nitrogen(BUN)], nuclear factor E2-related factor 2/heme oxygenase-1(Nrf2/HO-1) pathway were compared between the groups before and after treatment.The occurrence of adverse reactions and adverse cardiovascular events after treatment were compared between the groups. Results After 72 h of treatment, LVEF, CI, SV, SDNN, RMSSD, Nrf2 and HO-1 protein levels in the high-dose group were higher than those in the medium-dose and low-dose groups(P0.05).Before treatment and 72 h after treatment, there was no significant difference in serum Scr, β2-MG and BUN levels between the groups(P>0.05).There was no significant difference in the total incidence of adverse reactions and the total incidence of adverse cardiovascular events between the groups(P>0.05). Conclusion The treatment of rhBNP combined with bisoprolol is effective in elderly AMI patients after PCI.Large doses of rhBNP can significantly improve cardiac function and heart rate variability, which may be related to the activation of the Nrf2/HO-1 signaling pathway, and has no significant effect on renal function damage, adverse reactions and adverse cardiovascular events.
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