脑钠肽对急性失代偿性心力衰竭的影响

目的探讨N-端B-型脑钠肽(NT-pro BNP)对急性失代偿性心力衰竭(ADHF)患者的影响及重组人脑钠肽(rh BNP)治疗ADHF的临床疗效。方法随机将67例ADHF患者分为常规组(n=37)和rh BNP组(n=30)。rh BNP组在常规组治疗药物上加用新活素(0.0075μg/kg.min)连续静脉滴注24 h,每周1次,连续4周。动态监测两组患者治疗前后临床症状、左室射血分数(LVEF)、NT-pro BNP,并随访6个月心血管事件。结果治疗后两组心功能均得到提高,以rh BNP组改善为明显,心功能评级由(3.67±0.48)降至(1.9±0.48),LVEF由治疗前(43.5±3.37)%升至(49.0±2.74)%,同时NT-pro BNP由(3634.5±541.48)ng/L降至(1306.5±19.80)ng/L,6个月内再住院率10.81%,病死率6.67%,均低于常规组。NT-pro BNP值与心力衰竭程度呈正相关。结论 rh BNP治疗能明显改善ADHF患者的心功能,提高生活质量和降低再住院率且安全有效。NT-pro BNP水平可以反映患者心衰的严重程度、评价治疗ADHF的效果。

Influence of N-terminal pro B-type natriuretic peptide on acute decompensated heart failure

Objective To investigate the influence of N-terminal pro B-type natriuretic peptide （NT-proBNP） on acute decompensated heart failure （ADHF）, and curative effect of recombinant human B-type natriuretic peptide （rhBNP） on ADHF. Methods The patients （n=67） were randomly divided into routine group （n=37） and rhBNP group （n=30）. On the base of routine group’s treatment, rhBNP group was additionally given rhBNP （0.0075μg/kg·min） continuously for 24 h, once a week for 4 w. The clinical symptoms, LVEF and NT-proBNP were monitored dynamically in 2 groups, and cardiovascular events were followed up for 6 m. Results The heart function was improved in 2 groups, heart function rating decreased from （3.67±0.48） to （1.9±0.48）, LVEF increased from （43.5±3.37）% to （49.0±2.74）%, and NT-proBNP decreased from （3634.5±541.48） ng/L to （1306.5±19.80） ng/L. Within 6 m, rehospitalization rate was 10.81%, and mortality was 6.67%in rhBNP group, which were lower than those in routine group. NT-proBNP was positively correlated to severity of heart failure. Conclusion The treatment with rhBNP can significantly improve heart function and quality of life, and reduce rehospitalization rate, so it is safe and effective in patients with ADHF. The value of NT-proBNP can reflect the severity of heart failure and can be used for reviewing curative effect.