新活素治疗急性心力衰竭的临床疗效分析

The efficacy analysis of recombinant human brain natriuretic peptide on patients with acute heart failure

目的对新活素(重组人脑利钠肽)治疗急性心力衰竭的疗效进行探讨和分析。方法将2009年4月~2011年6月共54例急性心力衰竭(acute heart failure,AHF)患者随机分为研究组和对照组各27例。两组患者均给予标准心力衰竭治疗,研究组在标准治疗的基础上加用新活素,对照组则加用硝酸甘油,持续滴注3 d,比较两组患者的临床症状、心功能、血浆B型脑钠肽(BNP)水平和用药24 h后液体入量和尿量差。结果研究组患者临床症状缓解情况明显优于对照组,总有效率分别为92.59%和77.78%,差异具有统计学意义(P<0.05)。在心功能的改善上研究组患者心功能明显缓解,左心室舒张末内径(LVDd)与左室射血分数(LVEF)均显示心脏搏出量明显好转,与治疗前相比差异具有统计学意义(P<0.05)。血浆BNP水平两组患者在治疗后均有下降,研究组的下降幅度明显较对照组大,差异具有统计学意义(P<0.05)。两组患者用药24 h后液体入量和尿量的比较中观察组液体差明显高于对照组,差异具有统计学意义(P<0.05)。结论新活素对于急性失代偿性心衰患者疗效优于硝酸甘油,能够有效缓解患者病情并改善预后,减少死亡率。

Objective To observe the efficacy of intravenous infusion recombinant human brain natriuretie peptide （rhBNP） on patients with acute heart failure. Methods A total of 54 patients who suffered from acute heart failure patients of Ill^IV New York Heart Association （NYHA） functional classification were randomized into observe group and control group （n=27 each）, The observe group received rhBNP and the control group was used with lasting vein pump of nitroglycerin for 3 days, all the patients were treated with traditional heart failure treatment. Two groups of patients with clinical symptoms, cardiac function, brain natriuretic peptide （BNP）, and the amount of liquid infusion and urination volume were observed. Results The clinical symptoms improvements were more significant in observe group compared to control group, total efficiency were 92.59% and 77.78% （P〈0.05）. LVDd and LVEF about cardiac function were improved in observe group compared with control group （P〈0.05）. BNP were decreased obviously after rhBNP or nitroglycerin infusion, were （90.23±40.19） pg/rnL and （98.64±38.57） pg/mL, （P〈0.05）. And the amount of change between liquid infusion and urination volume with two groups were （554.74± 140.42）mL and （271. 18 ＋ 147.69） mL. （P〈0.05）. Conclusion Intravenous injection of rhBNP is efficient for acute heart failure patients, it is also feasible for clinic use in AHF patients.