静脉滴注乌拉地尔对急性心力衰竭患者血浆脑钠肽水平的影响及意义

Effect of intravenous administration of urapidil on plasma brain natriuretic peptide level of patients with acute heart failure

目的探讨静脉滴注乌拉地尔对急性心力衰竭患者血浆脑钠肽（BNP）的影响及临床疗效。方法将50例因各种原因引起的急性心力衰竭患者，心功能按纽约心脏协会（NYHA）分为Ⅲ～Ⅳ级，随机分为乌拉地尔治疗组24例，对照组26例，两组均给予常规治疗，包括利尿剂、口服血管紧张素转换酶抑制剂、强心剂，治疗组在此治疗基础上静脉持续泵入乌拉地尔50～400μg／min，硝酸甘油对照组在常规治疗基础上持续静脉滴入硝酸甘油15～50μg／min，疗程为3～10天，通过观察两组患者血浆脑钠肽浓度变化来判断心功能改善情况。结果治疗组与对照组比较，BNP降低显著，（216．2±115．3）ng／L vs（446．5±104．4）ng／L（P〈0．01），左室射血分数增加明显，（42±8）％vs（36±6）％（P〈0．01），收缩压降低显著，（100．0±12，8）mmHg vs（111.0±14．3）mmHg（P〈0．01），心率降低，（95．0±10）次／min vs（88±12）次／min（P〈0．05）。未见严重不良反应。结论乌拉地尔能明显降低急性心力衰竭患者血浆BNP浓度，改善心功能，治疗急性心力衰竭安全有效。

Objective To explore the difference of brain natriuretie peptide（BNP） concentration and clinical effects in patients with acute heart failure who received urapidil treatment intravenously. Methods Fifty eases for various reasons in acute heart failure caused by cardiac function NYHA Ⅲ - Ⅳ of the patients were randomly divided into urapidil treatment group（24 eases）, control group（26 eases）, the two groups were given conventional treatment, including diuretics, oral angiotensin-eonverting enzyme inhibitors, tonic, in treatment group on the basis of this treatment intravenously pumped into urapidil 50-400 μg/min, nitroglycerin conventional treatment in control group on the basis of continuous intravenous infusion of nitroglycerin 15-50 μg/min, the treatment lasted for three to ten days, plasma BNP concentration of two groups was observed to judge cardiac function. Results Treatment group showed significant decrease in BNP compared with control group （216.2± 115.3） ng/L vs （446.5 ±104.4） ng/L（ P 〈0.01）, left ventrieular ejection fraction （42 ± 8）% vs （36 ± 6） % （ P 〈 0.01）, systolic blood pressure showed more decrease, （100.0±12.8） mm Hg than （111.0±14.3） mm Hg（ P 〈0.01） ,heart rate reduced significantly （95±10） beats/min vs （88 ± 12） beats/min（ P 〈 0.05）. No serious adverse reactions occurred. Conclusion Urapidil can significantly reduce plasma BNP level of acute heart failure patients,improve cardiac function as a safe and effective treatment for acute heart failure.