重组人脑钠肽对不同病因导致急性心力衰竭的疗效比较

Comparison of efficacy of recombinant human brain natriuretic peptide in treating acute heart failure induced by various causes

目的:比较重组人脑钠肽治疗缺血性心肌病和非缺血性心肌病所致急性心力衰竭的临床疗效差别及安全性。方法:选择急性心力衰竭患者119例,根据其病因分为缺血性心肌病组(n=67)和非缺血性心肌病组(n=52)。在标准抗心力衰竭治疗的基础上静脉注射重组人脑钠肽。监测2组治疗前、后24 h总尿量、氨基末端脑钠肽前体(NT-proBNP)、临床症状及血生化指标变化。观察重组人脑钠肽治疗期间药物不良反应及1个月内心血管不良事件的发生率。结果:2组患者治疗后的24 h总尿量较治疗前均显著增加(缺血性心肌病组P=0.000 1,非缺血性心肌病组P=0.015),NT-proBNP均显著降低(缺血性心肌病组P=0.021,非缺血性心肌病组P=0.043),但组间比较无差异。2组间总有效率、用药不良反应发生率及1个月内的不良事件发生率(心源性死亡率)也相似。结论:重组人脑钠肽对各病因造成的急性心力衰竭疗效相似,其药物不良反应及1个月内不良事件的发生率均无显著差异。

Objective To compare the clinical effect and safety of recombinant human brain natriuretic peptide（rhBNP） in acute heart failure caused by ischemie cardiomyopathy （ICM） and non-ischemic cardiomyopathy （non-ICM）. Methods One hundred and nineteen patients with acute heart failure were divided into the ICM group （n=67） and non-ICM group （n=52） according to the primary disease. Clinical symptoms,24 h total urine volume, serum N terminal-proBNP （NT-proBNP） level, blood biochemical indexes and adverse drug reaction were observed before and after rhBNP treatment on the basis of standard anti-heart failure therapy. The major adverse cardiac events （MACE） were also observed up to one month after rhBNP infusions. Results Compared with baseline level, 24 h total urine volume was increased （P=0.000 1 for ICM; P= 0.015 for non-ICM） and NT-proBNP was decreased （P=0.021 for ICM; P=0.043 for non-ICM） significantly in both groups after rhBNP infusion, but no statistically significant difference was observed between ICM and non-ICM. The efficacy, to- tal effective rate, adverse drug reaction and MACE of both groups were similar. Conclusions rhBNP could significantly improve the clinical symptoms of acute heart failure induced by different causes. The efficacy and safety of rhBNP were similar between the two groups.