重组人脑利钠肽治疗高原肺水肿的肺动脉压变化

Changes in pulmonary artery pressure during the treatment of high altitude pulmonary edema with recombinant human brain natriuretic peptide

目的 观察重组人脑利钠肽（rhBNP）治疗高原肺水肿（HAPE）的肺动脉平均压（MPAP）变化情况,进一步明确rhBNP治疗HAPE的机制.方法 收集我院2011年2月~2012年10月收治的HAPE患者98例,随机分为常规治疗组和rhBNP组.两组入院后都给予吸氧、利尿、镇静、扩张支气管、减轻心脏负荷等处理,rhBNP组同时给予rhBNP治疗,然后监测两组入院前及治疗24 h后MPAP的变化,比较两组降MPAP效果.结果治疗24 h后,rhBNP组MPAP较对照组明显降低（P＜0.01）,rhBNP组未发生药物相关的不良事件.结论 肺动脉压升高是HAPE的机制之一,rhBNP可降低HAPE患者的MPAP,为其治疗HAPE提供了理论依据.

Objective To observe the changes in the mean pulmonary arterial pressure （MPAP） of patients with high altitude pulmonary edema （HAPE） treated with recombinant human brain natriuretic peptide （rhBNP）, and to make clear the mechanism of treatment of HAPE. Methods Ninety eight patients with HAPE who were hospitalized between February 2011 and October 2012 were selected and randomly divided into conventional treatment group and rhBNP group. After the admission, both groups received the treatment of oxygen inhalation, diuresis, sedation, bronchi dilation, and heart unloading, etc. The rhBNP group received the treatment with rhBNP at the same time. The changes in the MPAP of both groups before the admission and 24 h after the treatment were monitored. The decreases of MPAP in the two groups were compared. Results The MPAP in the rhBNP group significantly decreased compared with that in the control group 24 h after the treatment （P 〈 0.01 ）. Medicine-related adverse reaction did not occur in the rhBNP group. Conclusion The increase of pulmonary artery pressure is one of the mechanisms of HAPE. RhBNP can reduce the MPAP of patients with HAPE,which provides a theoretical basis for the treatment of HAPE.