重组人脑利钠肽对老年充血性心力衰竭的疗效评价

目的：研究静脉注射重组人脑利钠肽（rhBNP）治疗老年充血性心力衰竭患者的疗效。方法：118例老年充血性心力衰竭患者被随机分为：常规治疗组（56例）,给予常规药物治疗;rhBNP组（n=62）,以rhBNP 1.5μg/kg静脉注射后,再以0.0075μg/kg连续滴注;观察两组治疗前后超声心动图变化,血浆N末端脑利钠肽前体（NT-proBNP）浓度的变化以及出院后患者主要心血管事件的发生情况。结果：与治疗前比较,治疗5d后rhBNP组左室射血分数明显提高（0.37±0.10）∶（0.44±0.09）,P〈0.05];两组血浆NT-proBNP水平均有明显下降常规治疗组（7532.7±1005.6）pg/ml∶（7056.5±998.3）pg/ml,rhBNP组（7565.1±1102.3）pg/ml∶（6206.7±1137.9）pg/ml,P〈0.05],且rhBNP治疗组下降更明显（P〈0.05）;两组患者治疗前后左心室舒张末期内径（LVEDd）无明显变化（P〉0.05）;在8个月的随访期内rhBNP组心脏不良事件少于常规治疗组（9.7%∶28.6%）。结论：重组人脑利钠肽是治疗老年充血性心力衰竭的有效药物。

Therapeutic effects of recombinant human brain natriuretic peptide on congestive heart failure in aged patients

Objective：To study the therapeutic effects of intravenous injection of recombinant human brain natriuretic peptide（rhBNP） on congestive heart failure（CHF） in aged patients.Methods： A total of 118 aged patients with CHF were randomly divided into routine treatment group（n=56,received routine drug treatment） and rhBNP group（n=62,received rhBNP intravenous injection with 1.5μg/kg within 90s followed by 0.0075μg/kg·min iv drop for 48h）.Changes of echocardiogram and plasma concentration of N terminal-proBNP（NT-proBNP） before and after treatment and incidence of main adverse cardiovascular events（MACE） post-discharge were observed and analyzed in the two groups.Results： Compared with before treatment,five days after treatment left ventricular ejection infraction significantly increased （0.37±0.10） vs.（0.44±0.09）,P0.05] in rhBNP group.Plasma levels of NT-proBNP of the two groups significantly decreased routine treatment group（7532.7±1005.6） pg/ml vs.（7056.5±998.3） pg/ml,rhBNP group（7565.1±1102.3） pg/ml vs.（6206.7±1137.9） pg/ml,P0.05],and it′s more significant in rhBNP group（P0.05）.Left ventricular end-diastolic dimension（LVEDd） of the two groups showed no significant changes before and after treatment（P0.05）.During follow up period of eight months,rhBNP group had fewer cardiovascular events（9.7%） than routine treatment group（28.6%）.Conclusion： Recombinant human brain natriuretic peptide is an effective drug for treatment of congestive heart failure in aged patients.