重组人脑利钠肽治疗急性失代偿性心力衰竭的临床研究

目的：探讨冻干重组人脑利钠肽（rhBNP）对急性失代偿性心力衰竭的治疗效果和安全性。方法：选取40例急性失代偿性心力衰竭患者随机分为rhBNP组（n=20）和对照组（n=20）。rhBNP组以rhBNP1.5μg／kg静脉注射后，再以0.0075μg／kg持续静脉泵入：对照组持续静脉泵入硝普钠。观察治疗前、治疗48h后心肌酶水平、心脏超声指标、每小时尿量的变化。安全性评估采用用药过程中及用药后定期测量血压、心率．并记录用药过程中的不良事件。结果：治疗48h后rhBNP组心肌酶水平、LVEF、每小时尿量均显著优于常规对照组（P〈0.05或P〈0.01）。rhBNP组的不良事件与对照组相比无差异。结论：rhBNP能显著改善急性失代偿性心力衰竭患者的血流动力学及全身临床状况．其安全性与硝普钠相似。

Clinical Study of Recombinant Human Nitriuretic Peptide in Decompensated Acute Heart Failure

Objective： To compare the efficacy and safety of intravenous infusion recombinant human brain natriuretic peptide（rhBNP） in treating patients with decompensated acute heart failure. Methods： 40 patients characterized of decompensated acute heart failure were randomly allocated to rhBNP（n=20） and nitroprusside（NIT, n=20）. The rhBNP group was respectively received rhBNP（1.5μ g/kg bolus intravenous injection followed by 0.0075 μg/（kg.min） for 48 hours）and NIT （intravenous injection till clinical effective dose for 48 hours）. Before treatment and after 48 hours＇ treatment, the levels of cardiac enzymes in blood serum, echocardiographie indicators, urine volume of each hour were detected. Blood pressure, heart rate, dyspnea grade and improvement in patient sympotoms and signs were evaluated and adverse drug reaction were documented. Results： The levels of cardiac enzymes in blood serum, LVEF and hour urine were more significant in rhBNP compared to NIT group. The total adverse events were comparable between the two groups. Conclusion： rhBNP is superior to nitroprusside in improving hemodynamics and symptoms. The safety ofrhBNP is similar to nitroprusside.