重组人脑利钠肽对急性冠脉综合征致急性心衰的疗效观察

目的观察国产重组人脑利钠肽（rhBNP）治疗急性冠脉综合征（ACS）致急性心衰的疗效及安全性。方法2005年12月—2007年12月在天津市天和医院心内科住院诊断为急性冠脉综合征致急性心衰患者36例,在常规使用利尿剂、抗凝、抗血小板聚集、调脂、及血管紧张素转换酶抑制剂、β受体阻滞剂等药物治疗基础上加用国产rhBNP,连用48h,测定治疗前和停止用药4h后的血浆中BNP水平,收缩压、舒张压、心率、左室射血分数LVEF（%）、左室舒末内径（LVED）、左房内径（LAED）等指标。比较rhBNP治疗前后上述指标的变化。结果rhBNP治疗后患者血浆中BNP水平降低（781.3±355.3）pg/ml（P〈0.01）,LVEF提高（6.11±4.2）%（P〈0.01）,心率下降（19.33±12.37）次/min（P〈0.01）,左房内径减少（5.56±3.10）mm（P〈0.01）,左室内径和收缩压变化无明显差异。结论急性冠脉综合征致急性心衰使用rhBNP静脉注射治疗是有效和安全的。

Clinical Observation of Recombinant Human Brain Natriuretic Peptide on Acute Heart Failure Induced by Acute Coronary Syndrome

[ Objective] To observe the efficacy and safety of China-made recombinant human brain natriuretic peptide （ rhBNP） on acute heart failure （ACS）. [ Methods]36 diagnosed cases of acute heart failure induced by ACS in Tianjin Tianhe Hospital during December 2005-- December 2007 were selected. China-made rhBNP plus conventional drug uses of diuretics, anticoagulation, anti- platelet aggregation, lipid-regulating, angiotensin-converting enzyme inhibitor, and β-blocker were administrated to these patients for continuous 48 hours, measuring the plasma BNP levels before and after 4 hours of drug use, systolic pressure, diastolic pressure, heart rate, left ventricular ejection fraction LVEF （ % ） ,left ventricular internal diameter （LVED） , left atrial diameter （ LAED ） and other indicators. The changes of above indicators were compared before and after the treatment of rhBNP . [ Results] After rhBNP treatment, plasma BNP level reduced to （781.3 ± 355.3） pg/ml（ P 〈 0.01） , LVEF increased to（6.11 ±4.2）% （P 〈 0.01 ） ,heart rate reduced to （ 19.33 ± 12.37 ） pulse/min （ P 〈 0.01 ）, LAED to （ 5.6 ±3.1 ） mm （ P 〈 0. 01 ） , the difference of changes between LVED and systolic pressure was not significant. [ Conclusion] Application of rhBNP intravenous in treatment of acute heart failure induced by ACS is effective and safe