重组人脑利钠肽对老年充血性心力衰竭的疗效评价

Therapeutic effects of recombinant human brain natriuretic peptide on congestive heart failure in aged patients

目的:研究静脉注射重组人脑利钠肽(rhBNP)治疗老年充血性心力衰竭患者的疗效。方法:118例老年充血性心力衰竭患者被随机分为:常规治疗组(56例),给予常规药物治疗;rhBNP组(n=62),以rhBNP 1.5μg/kg静脉注射后,再以0.0075μg/kg连续滴注;观察两组治疗前后超声心动图变化,血浆N末端脑利钠肽前体(NT-proBNP)浓度的变化以及出院后患者主要心血管事件的发生情况。结果:与治疗前比较,治疗5d后rhBNP组左室射血分数明显提高[(0.37±0.10)∶(0.44±0.09),P<0.05];两组血浆NT-proBNP水平均有明显下降[常规治疗组(7532.7±1005.6)pg/ml∶(7056.5±998.3)pg/ml,rhBNP组(7565.1±1102.3)pg/ml∶(6206.7±1137.9)pg/ml,P<0.05],且rhBNP治疗组下降更明显(P<0.05);两组患者治疗前后左心室舒张末期内径(LVEDd)无明显变化(P>0.05);在8个月的随访期内rhBNP组心脏不良事件少于常规治疗组(9.7%∶28.6%)。结论:重组人脑利钠肽是治疗老年充血性心力衰竭的有效药物。

Objective：To study the therapeutic effects of intravenous injection of recombinant human brain natriuretic peptide（rhBNP） on congestive heart failure（CHF） in aged patients.Methods： A total of 118 aged patients with CHF were randomly divided into routine treatment group（n=56,received routine drug treatment） and rhBNP group（n=62,received rhBNP intravenous injection with 1.5μg/kg within 90s followed by 0.0075μg/kg·min iv drop for 48h）.Changes of echocardiogram and plasma concentration of N terminal-proBNP（NT-proBNP） before and after treatment and incidence of main adverse cardiovascular events（MACE） post-discharge were observed and analyzed in the two groups.Results： Compared with before treatment,five days after treatment left ventricular ejection infraction significantly increased [（0.37±0.10） vs.（0.44±0.09）,P0.05] in rhBNP group.Plasma levels of NT-proBNP of the two groups significantly decreased [routine treatment group（7532.7±1005.6） pg/ml vs.（7056.5±998.3） pg/ml,rhBNP group（7565.1±1102.3） pg/ml vs.（6206.7±1137.9） pg/ml,P0.05],and it′s more significant in rhBNP group（P0.05）.Left ventricular end-diastolic dimension（LVEDd） of the two groups showed no significant changes before and after treatment（P0.05）.During follow up period of eight months,rhBNP group had fewer cardiovascular events（9.7%） than routine treatment group（28.6%）.Conclusion： Recombinant human brain natriuretic peptide is an effective drug for treatment of congestive heart failure in aged patients.