重组人脑利钠肽治疗老年难治性心衰的疗效观察

目的观察重组人脑利钠肽（rhBNP）治疗老年难治性心力衰竭（RHF）的临床疗效及安全性。方法将我院2010年1月～2014年1月收治的126例老年RHF患者随机分为观察组和对照组,每组63例。对照组给予常规抗心力衰竭治疗；观察组在对照组基础上,首先给予rhBNP 1.5μg/kg静脉负荷量,而后以0.0075μg/（kg·min）的速度维持静脉滴注72 h。治疗3 d,观察两组临床疗效,并测量治疗前后心率、血压、血氧饱和度、左室舒张末内径及左室射血分数,记录不良反应的发生情况。结果治疗结束后,两组临床症状均有不同程度的改善,观察组总有效率为88.9%,明显高于对照组的68.3%（P〈0.05）；观察组心率、血氧饱和度、左室舒张末内径及左室射血分数较治疗前均显著改善,且明显优于治疗后对照组（P〈0.05）；两组血压与治疗前相比无明显变化（P〉0.05）；观察组治疗期间1例（1.6%）出现低血压,给予减慢给药速度后不良反应消失,其余未见严重不良反应。两组不良反应发生率无明显差异（P〉0.05）。结论 rhBNP治疗老年RHF临床疗效确切,能显著改善患者的临床症状及心功能指标,具有良好的安全性。

Curative effect of rhBNP on refractory heart failure in senile patients

Objective To observe the curative effect of recombinant human brain natriuretic peptide（ rhBNP） on refractory heart failure（ RHF） in senile patients and the safety. Methods 126 senile patients with RHF hospitalized in the period from Jan.,2010 to Jan.,2014 were randomly divided into 2 groups： observation group and control group,63 in each; patients in both groups were given routine anti heart failure therapy,while the patients in observation group were added with loading dose of rhBNP（ 1. 5 μg /kg intravenously）,and followed by intravenous infusion of rhBNP at a rate of 0. 0075 μg /（ kg·min） for 72 hours; the course lasted for 3days; the clinical curative effects in the 2 groups were observed,and the heart rate,blood pressure,blood oxygen saturation,LVEDd and LVEF of patients were measured before and after treatment; the occurrence of side effect was recorded. Results After treatment,improvement was found in both groups; the total effective rate was 88. 9% in observation group,much higher than that in control group（ P〈 0.05）;the improvement of heart rate,blood oxygen saturation,LVEDd and LVEF in observation group was superior to that in control group（ P 〈 0. 05）; no obvious changes in blood pressure were found in both groups（ P 〉 0. 05）; A case of hypotension occurred in observation group（ 1. 6%） and was dismissed after decreasing the speed of drug application,no serious side effect was found in others;there existed no obvious difference in the occurrence of side effect between the 2 groups（ P 〉0. 05）. Conclusions rhBNP is of definite curative effect on RHF of the senile patients with good safety,and it can improve the clinical symptoms and heart function index.