早期应用重组人脑利钠肽抢救急性左心功能衰竭

目的探讨早期应用重组人脑利钠肽（rhBNP）抢救急性左心功能衰竭（ALHF）的临床效果。方法所有ALHF患者均进行吸氧、强心、利尿、扩张血管、镇静治疗,必要时给予机械通气,维持血氧饱和度〉90%,维持血压〉100/60mmHg。174例ALHF患者分为两组,对照组（69例）采取常规抢救;观察组（105例）在常规抢救基础上早期加用rhBNP,用法为冲击量rhBNP1.5μg/kg,静注,后以0.0075μg/（kg·min）持续静注24h以上。观察两组患者4h、24h症状缓解率和24h内病死率。结果对照组4h、24h症状缓解率和24h内病死率分别为81.16%（56/69）、88.41%（61/69）和10.14%（7/69）,观察组患者4h、24h症状缓解率和24h内病死率分别为92.38%（97/105）、97.14%（102/105）和1.90%（2/105）,均存在显著性差异（P〈0.05）。结论早期应用rhBNP抢救ALHF患者可提高4h、24h症状缓解率,降低24h内病死率。

Study of clinical value of applying recombination human brain natriuretic peptides in early stage of acute left heart failure

Objective To explore the clinical curative value of applying recombination human brain natriuretic peptides in early stage of acute left heart failure.Methods We collected 174 case samples of patients with acute left heart failure.All patients were treated with routine methods,such as cardiac tonic,diuresis,expansion of blood vessels and sedation to maintain their oxygen saturation above 90%,keeping machine ventilation support,and blood pressure above 100/60 mmHg.We divided them into two groups:group A(n=69):Patients were treated with routine methods.group B(n=105):Patients were treated by recombination human brain natriuretic peptides(rhBNP)in early stage,in addition to routine methods:jerk of rhBNP 1.5 μg/kg injection,following 0.0075 μg/kg·min for 24 hours.We analyzed the curative ratio and mortality rate after 4 hours and 24 hours.Results The cure rate and mortality rate 4 hours and 24 hours after treatment were 81.16%(56/69) VS.92.38%(97/105),88.41%(61/69) VS.97.14%(102/105)和10.14%(7/69) VS.1.90%(2/105) respectively.There was statistical difference between two groups(P<0.05).Conclusion Early stage bundle therapy can improve curative ratio and prognosis of acute left heart failure.