重组人脑利钠肽在老年重度心力衰竭患者中的疗效分析

Safety and efficacy of human recombinant B-type natriuretic peptide in treatment of elderly patients with decompensated heart failure

目的探讨国产重组人脑利钠肽在老年重度心力衰竭患者中的疗效及安全性。方法回顾分析我院71例接受重组人脑利钠肽治疗的重度心力衰竭患者的临床资料,按照年龄分为≥70岁组(37例)和<70岁组(34例)。两组患者均接受48 h重组人脑利钠肽治疗,观察用药前后患者呼吸困难症状改善情况,检测患者血清肌酐(Cr)、B型尿钠肽激素前体(NT-proBNP)水平,采用彩色超声心动仪检测LVEF,记录患者30天及3个月的死亡事件。结果≥70岁组2例患者用药期间出现非药物相关性死亡,其余患者均完成48 h药物治疗,无低血压等不良反应的发生;与用药前比较,两组患者用药后呼吸困难症状有缓解(P<0.05);血清NT-proBNP明显减低(P<0.01);但两组患者用药后血清Cr、NT-proBNP及LVEF比较,差异无统计学意义(P>0.05)。两组患者用药后30天及3个月的病死率比较,差异无统计学意义(16.2% vs 11.8%;29.7% vs 29.4%,P>0.05)。结论老年重度心力衰竭患者静脉使用重组人脑利钠肽是安全、有效的。

Objective To evaluate the safety and efficacy of human recombinant B-type natriuretic peptide（r hBNP） in treatment of elderly patients with acute decompensated heart failure. Methods Seventy-one patients were divided into two groups： ≥70 years group （n = 37） and ≥70 years group （n = 34）. The clinical data of improvement in dyspnea,the levels of serum creatinine and NT-proBNP, the death in 30 days and 3 months after therapy with hBNP were analyzed retrospectively. Results Two patients of ≥70 years group died during therapy period,which was not related to the medicine. The others all received treatment with 48-hour intravenous injection. Improvement of dyspnea happened and the level of NT-proBNP decreased remarkably after treatment （P〈 0.01） in both groups. However,the level of serum creatinine,NT-proBNP,BP and LVEF did not show statistically significant difference between two groups. No significant difference in fatality rates was found in 30 days and 3 months between the two groups. Conclusion rhBNP can remarkably relieve the clinical symptoms of acute decompensated heart failure. It is safe and effective for elderly patients with acute decompensated heart failure.