重组人脑利钠肽治疗急性心力衰竭23例临床分析

目的探讨重组人脑利钠肽（rhBNP）治疗急性心力衰竭的疗效和安全性。方法将45例急性心力衰竭患者随机分为两组,rhBNP组（n=23）以rhBNP1.5μg/kg静脉注射后,再以0.0075μg/kg连续滴注;对照组（硝普钠NIT,n=22）静脉持续泵入硝普钠,起始剂量10μg/min,每次增加5μg/min,直到达到临床效应,连用72h。记录两组治疗前后临床疗效、全身情况、血流动力学、心脏收缩功能相关指标。rhBNP组安全性评估采用用药过程中及用药后定期测量血压、心率,并对过程中所有不良事件进行记录。结果治疗72h后rhBNP组临床疗效、心率和尿量优于对照组（P〈0.05）;rhBNP组治疗后左室收缩舒张功能指数较对照组明显改善（P〈0.05）。在与药物相关不良反应方面,两组差异无统计学意义（P〉0.05）。结论 rhBNP能改善急性心力衰竭患者的心率,尿量和临床状况,心脏超声提示心脏收缩舒张功能明显改善,治疗安全可靠。

Recombinant human nitriuretic peptide in the treatment of decompensated acute heart failure

Objective To compare the efficacy and safety of intravenous infusion recombinant human brain natriuretic peptide（rhBNP）in the treatment of decompensated acute heart failure.Methods 45 patients with decompensated acute heart failure were randomly allocated to rhBNP and nitroprusside （NIT） groups.Each group was respectively received rhBNP（1.5μg/kg bolus intravenous injection followed by 0.0075μg/kg·min for 72 hours,n=23） and NIT（starting at 10μg/min and increasing 5μg/min each time till clinical effectivendose for 72 hours,n=22）.The clinical effectiveness,general physical condition,hemodynamics and the systolic and diastolic function of heart were recorded before and after treatment in two groups.Blood pressure,heart rate and improvement in patient sympotoms and signs were evaluated,and adverse events were documented.Results The heart rate,urine and symptom improvements were more significant in rhBNP than those in NIT group（P0.05）.The levels of index of left ventricular contraction and relaxation functions in rhBNP group were higher than those in control group after treatment （P0.05）.The total adverse evernts were similar in the two groups.Conclusion rhBNP is superior to sodium nitroprusside for improving heart rate,urine and symptoms as well as the systolic and diastolic function of heart in the patients with acute heart failure,and the safety of rhBNP was similar to nitroglycerin in treating acute heart failure.