重组人脑利钠肽治疗心力衰竭诱发心肾综合征患者的研究

目的探讨重组人脑利钠肽(新活素)治疗心力衰竭诱发心肾综合征患者的疗效.方法将射血分数降低[左心室射血分数(LVEF)<50%)]的心力衰竭诱发心肾综合征患者200例分为病例组(使用新活素)100例和对照组(未使用新活素)100例.两组患者均采用心力衰竭诱发心肾综合征的常规治疗方案,病例组在此基础上加用新活素治疗至少72 h.两组患者治疗前后均行超声心动图、氨基末端脑利钠肽前体(NT-proBNP)、肾功能[尿素氮(BUN)和肌酐(Cr)]、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素(IL)-6及24 h尿量检查并进行比较.结果病例组治疗前后左心室舒张末期内径(LVIDd)、LVEF、NT-proBNP、BUN、Cr、CRP、PCT、IL-6及24 h尿量差值均大于对照组[(5.10±1.50)mm比(4.70±1.20)mm;(10.10±1.30)%比(6.70±1.10)%;(1079.60±55.70)ng/L比(209.00±27.60)ng/L;(30.60±5.70)mmol/L比(9.04±1.62)mmol/L;(6.80±1.70)μmol/L比(3.01±0.47)μmol/L;(5.29±0.27)mg/L比(3.09±0.11)mg/L;(0.22±0.07)ng/mL比(0.09±0.01)ng/mL;(6.28±0.26)pg/ml比(2.99±0.15)pg/ml;(1362.00±240.30)ml比(1234.00±209.70)ml],差异有统计学意义(P<0.05或P<0.01).结论与常规药物治疗比较,加用新活素可进一步改善心力衰竭诱发心肾综合征患者的心功能、肾功能及炎症反应程度.

Research of recombinant human brain natriuretic peptide in patients with heart and kidney syndrome caused by heart failure

Objective To explore the efficacy of recombinant human brain natriuretic peptide (neocitin) in patients with heart and kidney syndrome caused by heart failure. Methods A total of 200 patients with heart and kidney syndrome caused by heart failure of reduced ejection fraction[left ventricular ejection fraction(LVEF)<50%)] were divided into case group(n=100) which uesd neocitin and control group(n=100) which did not use neocitin. Patients in the two groups both received conventional treatment of heart and kidney syndrome caused by heart failure, and patients in the case group were treated with neomycin for at least 72 hours at the same time. Echocardiography,aniino-terniinal brain natriuretic peptide precursor(NT-proBNP), renal function [ urea nitrogen (BUN) and creatinine (Cr)], C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6 and 24h urine volume were examined and compared before and after treatment. Results The differences of left ventricular end-diastolic diameter (LAIDd), LVEF, NT-proBNP,BUN,Cr,CRP,PCT, IL-6 and 24h urine volume before and after Ireatment in the case group were significantly greater than those in the control group[(5. 10±1.50) mm vs (4. 70±1.20) mm;(10. 10±1. 30)% vs (6. 70±1. 10)%;(1 079. 60±55. 70) ng/L vs (209. 00±27. 60) ng/L;(30. 60 ±5.70)mmol/L vs (9.04±1.62) mmol/L;(6. 80±1.70)μmol/L vs (3. 01±0. 47)μmol/L;(5. 29 ±0. 27) mg/L vs (3. 09±0. 11) mg/L;(0. 22±0. 07) ng/ml vs (0. 09±0. 01) ng/ml;(6.28±0.26)pg/ml vs (2.99 ±0. 15)pg/ml;(1 362. 00 ±240. 30) ml vs (1 234.00± 209. 70) ml,P <0. 05 or P <0.01 . Conclusion Compared with conventional drug therapy, the addition of neocitin can furtherly improve heart function, renal function and degree of inflammatory response in patients with heart and kidney syndrome caused by heart failure.