脑钠尿肽治疗重症充血性心力衰竭患者的疗效

Effect of brain natriuretic peptides in treatment of patients with severe congestive heart failure

目的:观察脑钠尿肽(BNP)治疗重症充血性心力衰竭(CHF)患者的疗效。方法:纽约心脏学会心功能分级IV级的重症CHF患者44例,在基础抗心衰治疗基础上,应用重组人BNP(rh-BNP)进行治疗,观察患者心率、血压、出入量、中心静脉压、肾功能、血浆BNP水平、左心室舒张末径(LVEDD)和左心室射血分数(LVEF)的变化,观察BNP的疗效。结果:44例患者中40例患者心衰症状明显改善,总有效率91%。治疗后患者尿量明显增加,心率、中心静脉压、血浆BNP水平均较治疗前明显下降,LVEDD缩小,LVEF较治疗前升高,治疗前后血压和肾功能无明显改变。结论:外源性rh-BNP的应用可以明显改善患者心衰症状。治疗重症CHF安全,可靠。

AIM： To observe the therapeutic effect of brain natriuretic peptide （BNP） in the treatment of severe congestive heart failure. METHODS： Recombinant BNP was used based on basic anti-heart failure treatment in 44 patients with severe congestive heart failure and heart function classified as New York Heart Association （NYHA） IV. Changes in heart rate, blood pressure, central venous pressure, renal function, plasma BNP level, left ventricular end-diastolic diameter （LVEDD） and left ventricular ejection fraction （LVEF） after treatment were observed to evaluate BNP effect. RESULTS： After treatment, clinical symptoms in 40/44 cases were alleviated and the total response rate was 90.9%. Diuresis increased significantly and, at the same time, heart rate, central venous pressure and plasma BNP level decreased markedly. LVEDD was reduced and LVEF was improved. No obvious changes were observed in blood pressure and renal function. CONCLUSION： Recombinant BNP markedly alleviated the clinical symptoms of heart failure. It is a safe and effective treatment for severe congestive heart failure.