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1.
张德春 《重庆医学》2012,41(27):2804-2806,2809
目的探讨重组人脑利钠肽(rhBNP)治疗顽固性心力衰竭(RHF)的疗效和安全性。方法将86例RHF患者采用单盲法随机分为常规治疗联合静脉滴注硝酸甘油(NTG)治疗组(NTG组,n=43)和常规治疗联合rhBNP治疗组(rhBNP组,n=43)。NTG组患者NTG初始以5μg/min的速率静脉泵入,然后根据患者的血压、心率,每3~5分钟增加5~10μg,至20μg/min,连用3d;rhBNP组rhBNP首次负荷剂量1.5~2.0μg/kg静脉推注,继而以速率0.007 5~0.010 0μg.kg-1.min-1,连续静脉泵入3d。停用NTG和rhBNP后,继续常规抗心力衰竭治疗,7d后比较两组患者治疗前、后的临床症状、心功能、尿量,以及血浆BNP、肌酐、钠、钾浓度的变化及不良反应的发生率。结果与NTG组比较,rhBNP组患者临床症状(血压、尿量、呼吸困难程度)、心功能及血浆BNP水平都得到明显改善(P<0.05);且rhBNP组患者不良反应发生率与NTG组比较,差异无统计学意义(P>0.05)。结论 rhBNP能明显改善RHF患者的临床症状、心功能及血浆BNP水平,其用于治疗RHF疗效显著,安全性高。  相似文献   

2.
目的探讨重组人脑钠肽(rhBNP)治疗扩张型心肌病顽固性心力衰竭的临床疗效。方法 50例扩张型心肌病顽固性心力衰竭患者随机分为重组人脑钠肽治疗组和米力农对照组各25例。2组均给予常规抗心力衰竭药物治疗,治疗组给予注射用rh BNP,对照组给予米力农静脉滴注。观察2组治疗后的临床疗效,心率、平均动脉压、尿量、心功能及血浆BNP水平变化。结果治疗后1周,治疗组总有效率为88.0%,明显高于对照组的64.0%,差异有统计学意义(P<0.05)。治疗后24 h,2组心率明显下降(P<0.05),平均动脉压明显降低(P<0.05),尿量明显增加(P<0.01),且治疗组心率下降、尿量增多均优于对照组(P<0.05)。2组治疗后24 h血浆BNP水平较基线值明显降低(P<0.01),治疗后1周治疗组的左心室射血分数(LVEF)较治疗前提高(P<0.05);血浆BNP显著降低,治疗组治疗后LVEF改善和血浆BNP降低均明显好于对照组(P<0.01或P<0.05)。结论 rhBNP治疗扩张型心肌病顽固性心力衰竭患者疗效显著,可明显改善患者的心力衰竭症状。  相似文献   

3.
目的评价不同剂量冻干重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)治疗难治性心力衰竭(RHF)的临床疗效。方法四川省仁寿县人民医院将80例经常规抗心力衰竭药物治疗无明显改善的RHF患者随机分为小剂量组(n=36)和大剂量组(n=44)。首次负荷剂量1.5μg/kg静脉推注后,小剂量组以0.0075μg/(kg·min)继续静脉泵入维持治疗48h,大剂量组以0.01μg/(kg·min)维持治疗48h。观察2组患者治疗后心功能改善情况,以及24h尿量、左室射血分数(LVEF)和血浆脑钠肽(BNP)水平。结果 2组心功能改善总有效率分别为80.6%、88.6%,差异无统计学意义。使用不同剂量rhBNP治疗后,2组患者24h尿量较用药前明显增多,LVEF明显增加、血浆BNP水平明显下降,大剂量组改善更为显著,2组差异有统计学意义(P〈0.05)。结论 rhBNP可以明显改善难治性心力衰竭患者近期心功能状态,缓解患者的症状,表现为尿量增多、LVEF升高,且不同剂量rhBNP对上述指标改善不同,但并不影响心功能的改善程度。  相似文献   

4.
孙艳霞 《当代医学》2016,(15):144-145
目的 探讨重组人脑利钠肽(rhBNP)与参附注射液联合治疗急性心肌梗死(AMI)伴急性心力衰竭(AHF)患者的临床效果与评价.方法 入选患者随机分为rhBNP治疗组和rhBNP联合参附注射液治疗组,各31例.rhBNP组先静脉内推注rhBNP;负荷剂量,1.5μg/kg在90 s内推注完,续以0.0075μg/(kg·min)持续静脉泵入48 h.在保证SBP 130~90 mmHg及DBP 80~60 mmHg的情况下,维持剂量可滴定至0.015~0.030μg/(kg·min).rhBNP联合参附注射液治疗组rhBNP使用方法相同,同时联合应用参附注射液治疗7天,参附注射液;用量:5%葡萄糖注射液250 mL+参附注射液40 mL静脉滴注,每天1次.结果 与rhBNP联合参附注射液治疗组比较,rhBNP组用药后24hSBP(P<0.01)、DBP(P<0.05)较治疗前下降的幅度更明显,之后2组血压不再有明显的变化.2组心率下降均在用药后第2天最明显(P<0.05).与治疗前比较,2组治疗后血K+、Na+均无明显变化.联合治疗组治疗期间每24h的尿量明显多于rhBNP组(P<0.05).结论 参附注射液联合rhBNP治疗AMI伴AHF更安全有效.  相似文献   

5.
目的:研究静脉注射重组人脑利钠肽(rhBNP.)治疗急性心肌梗死伴心力衰竭患者的疗效.方法:2006年8月-2008年8月住院的急性心肌梗死伴心力衰竭患者81例,随机分为常规治疗组(n=43)和rhBNP治疗组(n=38),常规治疗组:予病因、强心、利尿、扩血管治疗,rhBNP治疗组:常规治疗基础上加静脉注射rhBNP[90 s 匀速静脉注射冲击量1.5μg/kg,0.0075μg/(kg·min)维持静脉注射48 h].应用USCOM无创血流动力学监测系统监测各组治疗前、治疗后30 min、1、3、6、12、24和48 h的血流动力学参数和48 h的尿量、血肌酐、血钾、血钠.结果:rhBNP静脉注射后外周血管阻力(SVR)较治疗前下降(P<0.05),每搏输出量(SV)、心脏指数(CI)、总尿量(UR)较治疗前升高(P<0.05),血肌酐(CR)较治疗前下降(P<0.05),较之常规治疗组的变化更明显.结论:急性心肌梗死伴心力衰竭患者静脉注射rhBNP较之单纯常规治疗有着更好的血流动力学效应和临床效果.  相似文献   

6.
重组人脑利钠肽治疗急性心力衰竭32例临床观察   总被引:2,自引:2,他引:2  
曹优文  张安客 《重庆医学》2008,37(13):1469-1470
目的探讨冻干重组人脑利钠肽(rhBNP)治疗急性心力衰竭的疗效和安全性。方法32例急性心力衰竭患者随机分为两组,rhBNP组(n=15):先以rhBNP 1.5μg/kg静脉冲击后,再以0.007 5μg.kg-1.min-1连续静脉滴注;对照组(n=17)静脉持续泵注硝普钠。记录两组治疗前后呼吸困难程度、全身情况、左室射血分数(EF)和E/A指数等。rhBNP的安全性评估采用治疗药前后定期测量血压、心率,复查血电解质及肾功能,并对所有不良事件进行记录。结果治疗72h后rhBNP组呼吸闲难和临床状况好转率优于对照组(P<0.05);rhBNP组治疗后左室收缩舒张功能指数较对照组明显改善(P<0.05),rhBNP组未发生药物相关的不良事件。结论rhBNP能改善急性心力衰竭患者的呼吸困难程度和临床状况,心脏超声提示心脏收缩舒张功能明显改善,治疗安全可靠。  相似文献   

7.
目的探讨冻干重组人脑利钠肽(rhBNP)治疗急性失代偿性心力衰竭的早期疗效和安全性。方法40例急性失代偿性心力衰竭患者随机分为两组,rhBNP组(n=20):先以rhBNP 1.5μg/kg静脉冲击后,再以0.0075μg.kg-1.min-1连续静脉滴注;对照组(n=20)静脉持续滴注异舒吉(硝酸异山梨酯)或硝普钠。记录治疗前后呼吸困难程度、全身情况、左室射血分数(EF)和Tei指数。rhBNP的安全性评估采用治疗药前后定期测量血压、心率、复查血电解质及肾功能,并对所有不良事件进行记录。结果治疗72 h后rhBNP组呼吸困难和临床状况好转率优于对照组(P<0.05);rhBNP组治疗后左室Tei指数较对照组明显缩短(P<0.05),而两组治疗后EF无显著差异(P>0.05)。rhBNP组未发生药物相关的不良事件。结论rhBNP能改善急性失代偿性心力衰竭患者的呼吸困难程度和临床状况,较硝酸异山梨酯或硝普钠缩短Tei指数,提高早期心脏舒张功能,安全性可靠。  相似文献   

8.
目的:观察重组人脑利钠肽(rhBNP)治疗急性心肌梗死后失代偿性心力衰竭的临床疗效和安全性.方法:选择急性心肌梗死合并失代偿性心力衰竭、心功能Killip Ⅲ级的患者63例,随机分为rhBNP组(32例)和多巴酚丁胺组(31例),在标准抗缺血治疗和静脉用呋塞米针剂抗心衰治疗的基础上,分别加用rhBNP(1.5 μg·kg-1静脉推注后,以0.007 5~0.01 μg·kg-1·min-1,静脉微泵注射72 h)和多巴酚丁胺(2.5~10 μg·kg-1·min-1,静脉微泵注射72 h).在用药前及用药72 h后测定两组患者血脑钠肽(BNP)、左室射血分数(EF)值,重新评价患者心功能Killip分级,观察患者72 h治疗过程中利尿剂用量及血压的变化,并观察30 d内的病死率.结果:两组血BNP均下降,rhBNP组更加明显(P<0.01);与多巴酚丁胺组比较,rhBNP组EF及心功能Killip分级均改善(P<0.01),利尿剂用量减少(P<0.01);两组患者30 d病死率无明显差异(P>0.05).结论:与多巴酚丁胺比较,rhBNP能更好地改善急性心肌梗死后失代偿性心力衰竭患者的临床症状,但对预后的改善未见明显差异.  相似文献   

9.
目的 比较重组人脑利钠肽(rhBNP)和硝酸甘油对失代偿性心力衰竭的临床疗效.方法 我院50例失代偿性心力衰竭住院患者随机分为硝酸甘油组和rhBNP组,分别记录两组患者给药前及给药后30 min、6 h及24 h的呼吸困难程度以及整体临床情况.以及用药24 h后液体的出入量和血流动力学参数.其中硝酸甘油组使用硝酸甘油开始剂量为5?g/min.每3~5分钟增加5?g/min,根据个体的血流动力学参数来调整用量;rhBNP组使用rhBNP,首先以1.5 ?g/kg弹丸式静脉冲击,随后以0.0075 ?g穔g-1穖in-1连续静脉滴注72 h.结果 rhBNP组患者静脉给药后30 min和6h的呼吸困难好转程度(P值分别为0.042和0.019)和整体临床状况好转程度(P值分别是0.018和0.044)均显著优于硝酸甘油组,24h后两组未有明显差异(P值分别是0.192和0.179);用药24 h后的尿量rhBNP组(1513.8±242.9)ml明显多于硝酸甘油组(1341.2±239.7)ml(P=0.015);用药24h时rhBNP组患者射血分数的增加以及肺动脉压和收缩压的降低均明显多于硝酸甘油组(P值分别是0.001、0.000及0.002),用药72 h后rhBNP组室性期前收缩、成对期前收缩和阵发性室性心动过速等室性心律失常发作的次数明显减少(P值分别是0.000、0.001和0.002).结论 rhBNP通过促进尿量的排泄、降低肺动脉压及增加左室射血分数等途径明显改善失代偿性心力衰竭患者呼吸困难和整体临床状况,以及明显减少室性心律失常的发作.  相似文献   

10.
目的 探讨冻干重组人脑利钠肽(rhBNP)治疗急性失代偿性心力衰竭的早期疗效和安全性.方法 40例急性失代偿性心力衰竭患者随机分为两组,rhBNP组(n=20):先以rhBNP 1.5 μg/kg静脉冲击后,再以0.0075 μg·kg-1·min-1连续静脉滴注;对照组(n=20)静脉持续滴注异舒吉(硝酸异山梨酯)或硝普钠.记录治疗前后呼吸困难程度、全身情况、左室射血分数(EF)和Tei指数.rhBNP的安全性评估采用治疗药前后定期测量血压、心率、复查血电解质及肾功能,并对所有不良事件进行记录.结果 治疗72 h后rhBNP组呼吸困难和临床状况好转率优于对照组(P<0.05);rhBNP组治疗后左室Tei指数较对照组明显缩短(P<0.05),而两组治疗后EF无显著差异(P>0.05).rhBNP组未发生药物相关的不良事件.结论 rhBNP能改善急性失代偿性心力衰竭患者的呼吸困难程度和临床状况,较硝酸异山梨酯或硝普钠缩短Tei指数,提高早期心脏舒张功能,安全性可靠.  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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