重组人脑利钠肽应用于急性心肌梗死合并心功能失代偿患者的疗效观察

Clinical effects of recombinant human brain natriuretic peptide on patients with acute decompensated heart failure combined with acute myocardial infarction

目的观察重组人脑利钠肽(rhBNP)治疗急性心肌梗死合并心功能失代偿的效果。方法急性心肌梗死合并心功能失代偿的患者92例,分成硝酸甘油组57例和rhBNP组35例。比较两组患者间症状缓解情况、利尿药物使用情况、住院时间以及注射硝酸甘油和rhBNP相关并发症发生情况。结果在缓解呼吸困难和恢复完全平卧休息这两方面所需的时间,rhBNP组均显著少于硝酸甘油组[(5.34±1.45)h比(7.58±2.51)h,P<0.01;(10.31±3.41)h比(12.22±3.79)h,P=0.017]。此外,rhBNP组患者的住院时间也较硝酸甘油组显著缩短[(7.7±1.4)d比(8.7±1.2)d,P<0.01]。在引起低血压和由此而使用多巴胺的患者比例方面,两组之间差异无统计学意义。结论急性心肌梗死合并心功能失代偿患者,静脉应用rhBNP与硝酸甘油比较,能够更有效地缓解患者症状、减少利尿药物的使用。

Objective To investigate the clinical effects of recombinant human brain natriuretic peptide （rhBNP） on patients with acute decompensated heart failure combined with acute myocardial infarction （AMI）. Methods Ninety-two patients with acute decompensated heart failure combined with AMI were divided into rhBNP group （ n = 35 ） and nitroglycerin group （n = 57 ）. We observed the differences in relieving heart failure symptoms, the periods of the intravenous furosemide and hospital stay between both groups. Results Compared with nitroglycerin group, the time of symptom relieving and to supine position without dyspnea was significantly shorter [ （5.34± 1.45 ） h vs. （7.58±2. 51 ） h, P 〈 0. 01 ; （ 10. 31± 3.41 ） h vs. （ 12. 22± 3.79 ） h, P = 0. 017 ]. The hospital stay was significantly shorter in rhBNP patients [（7.7±1.4） dvs. （8.7±1.2） d, P〈0.01]. Conclusions Compared with intravenous nitroglycerin,, rhBNP could effectively relieve heart failure symptoms, decrease the doses of furosemide, and shorten the hospital stay in patients with acute decompensated heart failure combined AMI.