重组人B-型利钠肽对慢性心力衰竭患者的中远期疗效

目的研究重组人B-型利钠肽对慢性心力衰竭急性失代偿患者的中远期疗效。方法试验对入选的107例慢性心力衰竭急性发作患者的临床资料采用随机、开放、平行对照方法进行采集和统计分析。入选患者随机分配为rhBNP组(n=40)和对照组,rhBNP组是在心衰常规治疗的基础上,加用新活素。患者出院后进行随访6个月,根据随访结果,判定患者出院后无急性失代偿性心衰发作的NT-proBNP下降幅度界定值;行不同治疗组的出院后无急性失代偿性心衰发作的生存分析。结果 NT-proBNP下降幅度≥35%患者的无急性失代偿性心衰发作的累积生存率明显高于NT-proBNP下降幅度<35%患者,P=0.001。rhBNP组患者无急性失代偿性心衰发作的均数明显超过标准治疗组患者(P≤0.05)。结论 rhBNP组患者出院后无急性失代偿性心衰发作的累积生存率明显高于标准治疗组患者,且NT-proBNP下降幅度≥35%者,其累积生存率最佳。

Long Term Curative Effect of Recombinant Human B-Type Natriuretic Peptide on Acute Decompensated Heart Failure

Objective To investigate the long term curative effect of recombinant human B-type natriuretic peptide(rhBNP) on acute decompensated heart failure(ADHF).Methods A total of 107 patients characterized of acute exacerbation of chronic heart failure were enrolled in this randomized,open-label,parallel-design study.Then the patients were divided into rhBNP group(40 cases) and standard therapy group(67 cases).Both groups received the conventional treatment for heart failure,while the rhBNP group was given additional nesiritide.According to the results of six months follow-up to evaluate the cut-off level of NT-proBNP decrease when patients without ADHF during the clinical follow-up,and the survival analysis was done in patients without ADHF during the clinical follow-up in both groups.Results In the surviving patients without ADHF after hospital discharge,the cumulative survival rate of patients with NT-proBNP decrease rate more equal than 35% was higher than that less than 35%(P=0.001),The mean cumulative survival in rhBNP group was extremely higher than that in standard therapy group(P=0.021).Conclusion The cumulative survival of survivals without ADHF during the clinical follow-up in rhBNP group is better than that in standard therapy group,and NT-proBNP decreased-level≥35% has the highest cumulative survival of survivals without ADHF.