重组人脑利钠肽治疗重度心力衰竭的临床分析

Clinical analysis of recombinant human brain natriuretic peptide on severe heart failure

目的 分析重组人脑利钠肽（rhBNP,商品名：新活素）治疗重度心力衰竭的临床疗效.方法 选择93例重度心力衰竭患者,先静脉推注新活素负荷量1.5～2.0 μg/kg,继以0.0075～0.0100 μg·kg-1·min-1持续静脉滴注24～72 h,分析比较治疗前、后临床症状和体征及心功能的改善程度,并观察血压、心率、电解质等变化.结果 用药后第一个24 h尿量明显增多（P＜0.01）,心悸、气短症状显著改善,肺部啰音、水肿近乎消失（P＜0.01）,治疗后较治疗前左室射血分数（LVEF）明显改善（P＜0.05）,未见明显的低血压及电解质紊乱发生.结论 静脉应用rhBNP治疗心力衰竭患者疗效肯定,方法简便,副反应少,可作为重度心力衰竭患者的有效治疗措施.

Objective It is to analyze the clinical therapeutic effect of lyophilized recombinant human brain natriuretic peptide （rhBNP）on heart failure. Methods 93 patients with severe heart failure were all treated with loading dose 1.5-2.0μg/kg intravenous injection of rhBNP, and then maintained the therapy for 24 to 72 hours with the speed of 0.0075-0.0100 μg·kg^-1min^-1,clinical symptoms, physical signs, improvement of heart function pre-and post-treatment were analyzed and BP, HR, electrolytes were observed. Results The first 24 hour urine volume was obviously increased （P〈0.01）, palpitations and tachypnea were significantly improved, pul- monary rales and edema nearly disappeared （P〈0.01） after rhBNP infusion, the LVEF was notably increased than before rhBNP infusion（P〈0.05 ）, and apparent hypotension and electrolyte disturbance were not observed. Conclusion Intravenous application of rhBNP on severe heart failure has reliable therapeutic effect, ease of usage, fewer side effects, will be an effective treatment of severe heart failure.