微量泵入利尿合剂对难治性心力衰竭患者B型脑钠肽的影响

目的探讨微量泵泵入利尿合剂对难治性心力衰竭(CHF)患者B型脑钠肽(BNP)的影响。方法选择经1～2周正规抗CHF治疗,心功能Ⅲ一Ⅳ级患者70例,将其分为常规治疗组35例,利尿合剂治疗组35例(常规治疗加利尿合剂)。治疗前后测定BNP、平均心率、心律失常发生率及左心室射血分数(LVEF),治疗后判断疗效情况。结果利尿合剂治疗组显效率,及总有效率为71.4%和88.5%,均高于常规治疗组的40.0%和70.1%(P0.05),两组中反映心功能及病情变化的相关指标均有所改善,但前者改善更加明显(P0.01,P0.05),其中,BNP下降幅度最显著(P0.05)。结论难治性心力衰竭患者在常规治疗基础上加用利尿合剂,可明显改善心功能,更大程度地降低BNP水平。BNP对于评价心力衰竭的治疗反应具有一定参考价值。

The effect of diuretic mixture on type B natriuretic peptide in patients with refractory heart failure

Objective To investigate the reflection of BNP in the patients with congestive heart failure by treating with diuretic mixture.Methods After treated with one-two weeks routine measure,70 CHF patients with heart function Grade three-four were divided into two groups randomly:the conventional therapy group and diuretic mixture therapy group.Blood BNP、 average heart rate、arrhythmogenesis and LVEF were measured before and after the treatment.Results Total efficacy rate in the diuretic mixture group was much higher than the conventional therapy group(P < 0.05).The index of heart function such LVEF、 average heart rate、arrhythmogenesis and BNP were improved in both groups after the therapy(P < 0.05,P < 0.01),but Blood BNP concentration of the two group changed more than others(P < 0.05).Conclusion Diuretic mixture is more effective than the conventional therapy in treating refractory congestive heart failure and the degradation of the blood BNP level is in a larger extent than the conventional therapy.Blood BNP can be used as a reference value for therapeutic reaction in heart failure patients.