重组人脑利钠肽对舒张性心力衰竭患者心功能的影响

目的观察重组人脑利钠肽（rhBNP）对舒张性心力衰竭（DHF）患者心功能的影响。方法对98例入选患者进行随机开放对照临床试验。其中对照组（n=48）,接受常规治疗;人脑利钠肽组（n=50）,在常规治疗的基础上联合rhBNP治疗。在治疗前、治疗后2周及6个月时超声检测二尖瓣舒张早期血流与二尖瓣环舒张早期运动速度比值（E/Em）、左室质量指数（LVMI）、左房容积指数（LAVI）,测定血浆N端脑利钠肽前体（NT-proBNP）水平,测定6分钟步行距离并利用NYHA评价心功能,同时进行两组间比较。结果与对照组相比,治疗2周后人脑利钠肽组的NYHA心功能分级（均值）下降[（2.5±0.2）vs.（2.8±0.5）],6分钟步行距离延长[（427.5±45.4）mvs.（409.6±60.8）m],NT-proBNP水平下降[（653.8±67.5）ng/Lvs.（767.8±75.2）ng/L],E/Em值、LVMI值及LAVI值均降低[（12.8±2.6）vs.（14.2±1.4）,（140.3±12.3）g/m2vs.（148.4±13.2）g/m2,（33.4±2.1））ml/m2vs.（37.2±3.1）ml/m2],两组间差异均具有统计学意义（P〈0.05）,随访至6个月时上述各项指标仍无显著性差异（P〉0.05）。且治疗过程未发现与用药有关的不良反应。结论 rhBNP治疗舒张性心力衰竭近期疗效显著,安全性好。

Influence of recombinant human brain natriuretic peptide on cardiac function in patients with diastolic heart failure

Objective To observe the influence of recombinant human brain natriuretic peptide （ rhBNP ） on cardiac function in patients with diastolic heart failure （ DHF ） . Methods The chosen patients （ n =98 ） were given randomized, opened and controlled clinical trials. The control group （ n =48 ） was given routine treatment, and BNP group （ n =50 ） was given rhBNP treatment on the basis of routine treatment. Before treatment, after treatment for 2 weeks and after follow-up for 6 months, the ratio of inflow velocity and movement velocity （ E/Em ） in early mitral diastolic stage, left ventricular mass index （ LVMI ） and left atrial volume index （ LAVI ） were detected by using Doppler ultrasonography, the level of N-terminal pro-brain natriuretic peptide （ NT-proBNP ） was detected. The cardiac function grade of New York Heart Association （ NYHA ） and 6-minute walk distance test （ 6MWD ） were reviewed and compared between two groups. Results After two weeks and compared with control group, in BNP group cardiac function grade of NYHA （average value） decreased [ （ 2.5 ± 0.2 ） vs.（ 2.8 ± 0.5 ） ], 6MWD was prolonged [ （ 427.5 ± 45.4 ） m vs.（ 409.6 ± 60.8 ） m], and level of NT-proBNP decreased [ （ 653.8 ± 67.5 ） ng/L vs.（ 767.8 ± 75.2 ） ng/L], and the values of E/Em, LVMI and LAVI decreased [ （ 12.8 ± 2.6 ） vs.（ 14.2 ± 1.4 ） , （ 140.3 ± 12.3 ） g/m 2 vs. （ 148.4 ± 13.2 ） g/m 2 , （ 33.4 ± 2.1 ） ml/m 2 vs.（ 37.2 ± 3.1 ） ml/m 2 ] and the difference was statistically significant （ all P 0.05 ） . After follow-up for 6 months, there were no significant differences in all indexes （ all P 0.05 ） , and no adverse reactions observed. Conclusion RhBNP has significant short-term curative effect and reliable safety in the treatment of DHF.