新活素治疗老年慢性收缩性心力衰竭急性发作的疗效观察

目的研究新活素(冻干重组人脑利钠肽)治疗老年慢性收缩性心力衰竭急性发作的疗效和安全性。方法将40例老年慢性收缩性心力衰竭急性发作患者随机分为常规治疗组(未加用新活素)和新活素治疗组,两组均常规给予强心、利尿、扩血管治疗,新活素组在常规治疗基础上加用新活素,首次负荷剂量1.5μg/kg静脉注射,后持续0.0075μg/(kg.min)静注,连用3 d。记录治疗前后患者呼吸困难程度、肺部啰音、出入量、血浆BNP(脑利钠肽)水平、心室射血分数,同时定期监测治疗过程中的血压、心率变化,记录用药后所发生的所有不良事件。结果新活素治疗组的呼吸困难程度和肺部啰音、血浆BNP水平好转率显著优于常规治疗组,而两组患者出入量、心室射血分数改善情况比较无显著性差异;安全性方面:新活素治疗组更容易发生低血压事件,但两组比较无统计学意义。结论新活素可以显著改善老年慢性收缩性心力衰竭急性发作患者的呼吸困难,缓解临床症状;建议使用过程中密切监测血压变化。

Clinical observation of lyophilized recombinant human brain natriuretic pep-tide in treating acute exacerbation of chronic congestive heart failure with gerontal patients

Objective To explore the clinical curative effect and the safety of intravenous recombinanat human brain natriuretic peptide （rhBNP） in treating acute exacerbation of chronic congestive heart failure with gerontal patients. Methods A total of 40 gerontal patients characterized of acute exacerbation of chronic heart failure were enrolled in this sudy .The gerontal patients were randomly alloctated to two groups ,one was treated with standard therapy, anothet was treated with rhBNP based on stand therapy,priming dose of 1.5μg/kg,and then continuing dose of 0.0075μg/kg＇min for 3 days. Results In the efficacy respect,dyspnea was significantly improveed at 30 min and at 24 h after administration with rhBNP （P 〈 0.05）. Plasma BNP decreased at 3 days after adminstration with rhBNP （P 〈 0.05）. Urine output and LEVF were also observed at 3 days,but there was no difference between two groups （P 〉 0.05）. In terms of safety,the rate of hyptension was 7.5% after adminstration with rhBNP （P 〉0.05）. Conclusion The clinical application of intravenous rhBNP is asfe and effctive for treament of acute exacerbation of chronic heart failure in gerontal patients.