重组人脑利钠肽在心衰治疗中对肾功能影响的研究

The effect of recombinant human brain natriuretic peptide on renal function in treatment of patients with heart failure

目的 观察重组人脑利钠肽在治疗心衰中对肾功能的影响.方法 回顾性分析在我院住院诊断为心衰的患者75例,随机分为两组：rhBNP组35例,在常规治疗的基础上加用rhBNP;常规治疗组40例,给予常规治疗.重组人脑利钠肽按0.0075 μg＆#183;kg-1＆#183;min-1微量泵静脉泵入,每天1次,每次持续约10 h,7d为一疗程,分别记录治疗前和7d后患者的24h尿量、尿素氮、血清肌酐、血清胱抑素、肾小球滤过率及NT-proBNP的变化.结果 治疗后与常规治疗组比较,rhBNP组的总有效率（94.3％比62.5％）、24 h尿量[（965.34±171.81）ml比（785.27±143.45）ml]、尿素氮[（7.42±2.33）mmol/L比（12.89±3.16）mmol/L]、血清肌酐[（91.53±8.21） μmol/L比（232.68±68.95） μmol/L]、血清胱抑素C[（1.55±0.11）mg/L比（3.25±1.87）mg/L],24h肌酐清除率[（45.2±5.6）ml/min比（34.1±2.6）ml/min]、NT-proBNP[（1516.43±431.52）pg/ml比（3451.1±1314.2）pg/ml]差异均有统计学意义（P＜0.05）.结论 重组人脑利钠肽在心衰患者治疗中疗效安全有效,并能改善肾功能.

Objective To observe the effect of recombinant human brain natriuretic peptide on renal function in patients with cardiorenal syndrome. Methods 75 patients with heart failure were admitted to hospital. TYhey were randomly divided into rhBNP group （n=35, received rhBNP based on routine treatment） and routine treatment group（n=40, received routine treatment）, rhBNP was pumped with 0.0075 μg kg-l＂min-1 with one time per day for seven days, and each time was continued for ten hours. Urine volume of 24 hours, BUN, Scr, cystatin C, glomerular filtration rate and NT-proBNP were recorded. Results Compared with routine treatment group after treatment, there were siaificant increase in total effective rate （94.3% vs 62.5% ）, urine volume of 24 hours [（965.34±171.81）ml vs （785.27±143.45）ml], BUN [（7.42±2.33）mmol/L vs （12.89±3.16）mmo1/L~, Scr [（91.53±8.21）μmol/L vs （232.68±68.95）μmol/L], cystatin C [（1.55±O.11）mg/L vs （3.25±l.87）mg/LJ, glomerular filtration rate [ （45.2±5.6）ml/min vs （34.1±2.6）ml/min], NT-proBNP [ （1516.43±431.52）pg/ml vs （3451.1±1314.2）pg/ml], left ventrieular ejection fraction [（45.9±6.8）% vs （35.6±5.5）% 1 in rhBNP group. There were significant differences between the two groups（P〈0.05）. Conclusion Effect of the recombinant human brain natriuretic peptide for treatment in patients with heart failure showes to be security and improve kidney function.