重组人脑钠肽治疗冠心病合并急性心力衰竭疗效的性别差异

Sex differences in therapeutic outcomes of recombinant human brain natriuretic peptide in patients with coronary artery disease combined with acute heart failure

目的:探究重组人脑钠肽(rhBNP)治疗冠心病合并急性心力衰竭的临床疗效及安全性的性别差异。方法:入选冠心病合并急性心力衰竭发作患者67例,其中男性组33例,女性组34例。在标准抗心力衰竭治疗的基础上给予rhBNP静脉注射。观察两组治疗前后24 h总尿量、N端脑钠肽前体(NT-proBNP)、临床症状及血生化指标的变化。同时观察药物不良反应及1个月内心血管不良事件。结果:两组患者治疗后的24 h总尿量较治疗前均显著增高(P=0.002),女性组治疗后NT-proBNP水平显著降低(P=0.003),但两组间比较无统计学差异。男性组总有效率显著高于女性组(P=0.033),两组药物不良反应及1个月内的心源性死亡率相似。结论:rhBNP治疗对冠心病合并急性心力衰竭安全有效,但女性患者疗效低于男性。

Objective：To explore the gender-related differences of clinical curative effect and safety of recombinant human brain natriuretic peptide （rhBNP） in patients with coronary artery disease （CAD） combined with acute heart failure. Methods： A total of 67 CAD patients with acute heart failure were selected, including 33 men and 34 women. All patients were given rhBNP on the basis of standard anti- heart failure therapy. Clinical symptoms, 24-hour biochemical indexes and adverse drug effects were urinary output, serum NT-proBNP levels, other examined before and after rhBNP treatment. The major adverse cardiac events （MACE） were also observed up to 1 month after drug infusion. Results： Compared to the haseline levels, 24-hour urinary output significantly increased in hoth groups （P = 0. 002）and the reduction of NT-proBNP was statistically significant in women group（P = 0. 003） after rhBNP infusion. However, the between-group variation of 24-hour urinary output and NT-proBNP showed no significant differences. The total effective rate in men was significantly higher than that in women（P ： 0. 033）, but the adverse drug effects and MACE were similar. Conclusion： RhBNP significantly and safely improves clinical symptoms of CAD patients with acute heart failure, and the efficiency in men is higher than that in women.