重组人脑利钠肽治疗顽固性心力衰竭疗效观察

Effect observation of recombinant human brain natriuretic peptid for the treatment of refractory heart failure

目的观察重组人脑利钠肽(recombinant human brain natriuretic peptid,rhBNP)治疗顽固性心力衰竭的疗效及不良反应。方法收集我院自2008年6月至2009年5月收治的60例顽固性心力衰竭患者随机分为rhBNP组和对照组。实验组32例患者在常规治疗的基础上给予rhBNP治疗(rhBNP1.5μg/kg静脉冲击后,以0.0075μg/kg/min连续静注),而对照组28例患者在常规治疗的基础上给予硝普钠连续静滴,48h后观察两组患者的心功能改善情况、临床指标及药物不良反应。结果经过48h治疗,rhBNP组心功能改善的有效率及临床指证均明显优于对照组。与对照组相比,实验组hs-CRP及NT-proBNP明显下降,LVEF升高(P<0.05)。研究过程中没有患者由于药物的不良反应而退出。结论 rhBNP治疗顽固性心力衰竭较常规使用硝普钠治疗效果好,不良反应发生率低。

Objective To investigate the effect and the adverse reaction of recombinant human brain natriuretic peptid （rhBNP） for the treatment of refractory heart failure. Methods A total of 60 patients with refractory heart failure treated in our hospital from Jun, 2008 to May, 2009 were involved in this study. They were randomly divided into control group and rhBNP group. Based on routine treatment, 32 patients were assigned to receive rhBNP （1.5 μg/kg intravenous injection followed by 0.0075 μg/kg/min intervenous drop infusion） in the experiment group, while 28 were treated with sodium nitroprussiate in the control group. Cardiac function improvement, overall clinical conditions and the adverse reactions were measured in all patients after 48 h. Results After 48 h treatment, the total effective rates of cardiac ftmction improvement and the clinical conditions in the experimental group were all significantly better than that in the control group （P〈0.05）. Comparing with the control group, hs-CRP and NT-proBNP were decreased, but LVEF was increased significantly in the experiment group. No patients withdrawed the study due to adverse events. Conclusion rhBNP is superior to sodium nitroprussiate in treatment of refractory heart failure, and it has the advantage of low incidence of adverse effects.