不同剂量新活素治疗充血性心衰疗效和安全性观察

The efficacy and safety of Recombinant Human Brain Natriuretic Peptide in the treatment of congestive heart failure

目的评价不同剂量新活素治疗充血性心力衰竭(CHF)的疗效及其不良反应。方法 A组30例,给予新活素0.1μg/kg的负荷量静脉注射,随后予0.01μg/(kg·min)持续静脉泵入24 h;B组30例,给予新活素0.1μg/kg的负荷量静脉注射,随后予0.015μg/(kg·min)持续静脉泵入24 h。观察两组用药前后生命体征、呼吸困难程度、体循环淤血及N-末端脑钠肽前体(N-terminal proBNP,NT-proBNP)的变化;1个月时6分钟步行距离和超声心动图评估左心室舒缩末期各径线、左心房径及EF。结果两组比较,在改善呼吸困难和体循环淤血程度等临床症状方面差异有统计学意义(P<0.05);两组患者NT-proBNP水平均较前下降(P<0.05),但两组之间变化差异无统计学意义(P>0.05);1个月时6 min步行距离差异有统计学意义(P<0.05),LVEDD、LVEF差异无统计学意义(P>0.05);低血压、肾功能损害和电解质紊乱的发生率两组之间差异无统计学意义(P>0.05)。结论新活素治疗CHF疗效显著,0.1μg/kg的负荷量静脉注射,随后予0.015μg/(kg·min)持续静脉泵入24 h的疗效更好。

Objective To evaluate the efficacy and safety of Recombinant Human Brain Natriuretic Peptide （RHBNP） in treating CHF at different doses. Methods 60 patients suffered from CHF were enrolled in this study. Patients in group A （n =30） were treated with RHBNP at the dose of 0. 1μg/kg through intravenous injection and followed by the dose of 0.01μg/ （kg ＊ min-1） for 24 hours through intravenous infusion. Patients in group B （ n = 30） were treated with RHBNP at the dose of 0.1 μg/kg through intravenous injection and followed by the dose of 0. 015 μg/ （kg ＊ min-1） for 24 hours through intravenous infusion. Blood pressure, heart rate, the degree of dyspnea, symptoms and NT-pro BNP wero evaluated. Evaluate the radial line, LVEDD and LVEF according to the walking distance in 6min and ultrasonic heartbeat diagram. Results Improvements of dyspnea grade and symptom in group B were better than those of group A （ P 〈 0. 05 ）. NT-proBNP levels of both groups decreased compared to the concentration^before treatment （ P 〈 0.05 ） , and the differences between the two groups present no statistically significant （ P 〉 0.05 ）. Walk distance in 6rain of the two groups were different from each other （P 〈 0. 05 ）. The changes of cardiac function, hypotension and impaired renal function between the two groups had no statistically differences after treatments （P 〉 O. 05 ）. Conclusions RHBNP was effective for the treatment of CHR, and will got better efficacy at the dose of 0.1μg/kg through intravenous injection and followed by the dose of 0.01μg/ （ kg ＊ min -1） for 24 hours through intravenous infusion.