新活素治疗急性左心衰患者及对肾功能的影响

目的：探讨新活素治疗急性左心衰的疗效及对肾功能的影响.方法：将96 例急性左心衰患者随机分为治疗组和对照组,治疗组在对照组基础上加用新活素（rhBNP）,测定两组治疗前及治疗后1 h、3 h、6 h 的肺毛细血管楔嵌压（PCWP）、肺动脉压（PAP）,1 周时左室射血分数（LVEF）、左室舒张末期容积（LVEDD）、左室收缩末期容积（LVESD）、血肌酐及血尿素氮.结果：治疗组的总有效率为89.8%,对照组总有效率为57.4%,两组比较差异有统计学意义（P〈0.05）.治疗前后1 周两组患者LVEDD、LVESD、血肌酐及血尿素氮的改变差异无统计学意义（P〉0.05）,但治疗组LVEF 较对照组明显改善（P〈0.05）.治疗组给药后第1、3、6小时的PCWP 及PAP 降低值明显高于对照组（P〈0.05）.结论：新活素对急性左心衰的疗效显著,对肾功能无影响.

Clinical Observation on rhBNP in Treating with Acute Left Heart Failure and the Effect of rhBNP on Renal Function

Objective ： To investigate efficacy of rhBNP in treating patients with acute left heart failure and the effect of rhBNP on renal function. Methods ： 96 patients with acute left heart failure were randomly divided into treatment group and control group. PCWP and PAP were measured before and one hour, three hours, six hours after treatment. The value of LVEF, LVEDD, LVESD, serum creatinine and uric acid nitrogen was measured before treatment and one week after treatments. Results ： The total efficiency of A group was 89.8% and the total efficiency of B group was 57.4%. The curative effect of treatment group was better than that of control group（P〈0.05）. Before and one week after treatment comparison, the variance of the value of LVEDD, LVESD, serum creatinine and uric acid nitrogen had no statistically difference（P〉0.05）, but the value of LVEF of A group was higher than that of control group（P〈0.05）. Compare before treatment to one hour, three hours, six hours after treatment, the lower value of PCWP and PAP of treatment group were higher than those of control group（P〈0.05）. Conclusion ： The clinical efficacy of rhBNP in treatment of acute left heart failure is significant, and the rhBNP on renal function has no effect.