冻干重组人脑利钠肽对急性失代偿心力衰竭的临床疗效分析

目的评价国产重组人脑利钠肽(rhBNP)对急性失代偿性心力衰竭(ADHF)患者的临床疗效及不良反应。方法选取急性失代偿性心力衰竭患者15例,男12例,女3例,平均年龄(63.2±19.8)岁,在常规治疗(洋地黄类、血管扩张剂等)效果不佳的基础上使用rhBNP。回顾性分析、比较rhBNP治疗前后患者呼吸困难、临床体征、尿量、血压、心率、血生化改变情况。结果 rhBNP可明显改善患者呼吸困难及水肿(P<0.05),但对肺部啰音改善不明显。用药后72 h内,开始心率有上升趋势,但与治疗前比较差异无统计学意义(P>0.05),此后心率波动性下降,最低(72.1±18.0)次/min,较开始用药时显著下降(P<0.05)。用药初血压有轻度下降,但很快恢复,用药前后血压差异无统计学意义(P>0.05)。结论 rhBNP对常规治疗效果不佳的急性失代偿性心力衰竭患者疗效明显,能改善患者呼吸困难及水肿,相应降低心率,增加其尿量,且对血压、血离子、肝功、肌酐无明显影响。

Clinical efficacy of lyophilized recombinant human natriuretic peptide on acute decompensated heart failure

Objective To observe the clinical efficacy and adverse reactions of recombinant human natriuretic peptide(rhBNP)on ADHF,and provide references for clinical application.Methods 15 patients presenting with ADHF were enrolled,including 12 males and 3 females with the average age(63.2±19.8)year-old.The rhBNP was used on the ineffective basis of conventional therapy(digitalis category,vascular dilation,etc.).The dyspnea,clinical signs,urine,blood pressure,heart rate and blood biochemical changes were analyzed before and after treatment.Results Dyspnea and edema were significantly improved(P<0.05),but pulmonary rale had no difference after using rhBNP.At 72 h after the administration,the heart rate raised at beginning,but had no significant difference from pretherapy of rhBNP(P>0.05),then fluctuations decreased[(72.1±18.0)bpm at the lowest,P<0.05].The blood pressure dropped lightly early after treatment,but soon resumed(P>0.05).Conclusion The efficacy of rhBNP on ADHF who got poor effects from conventional treatment is obvious by improving symptoms of dyspnea and edema,increasing urinary volume,and it has no significant impact on blood pressure,blood plasma,liver function and creatinine.