冻干重组人脑利钠肽治疗急性失代偿性心力衰竭临床观察

Clinical observation of lyophilized recombinant human brain natriuretic peptide for the treatment of acute decompensated heart failure

目的研究冻干重组人脑利钠肽治疗急性代偿性心力衰竭的临床效果。方法选择急性失代偿性心力衰竭患者90例，随机分成观察组（45例）和对照组（45例）。对2组患者均进行常规治疗，观察组同时静脉注射冻干重组人脑利钠肽；对照组则静脉注射硝酸甘油。结果治疗前观察组和对照组左心室舒张末期内径（LVEDD）及左心室射血分数（LVEF）差异无统计学意义（P〉0．05）。治疗后观察组LVEDD显著小于对照组（P〈0．01），LVEF显著高于对照组（P〈0．01）。治疗前2组患者动脉血二氧化碳分压（PaCO2）、时间肺活量、收缩压及动脉血氧饱和度比较差异均无统计学意义（P〉0．05）。治疗后观察组PaCO2、收缩压显著低于对照组（P〈0．01），时间肺活量和动脉血氧饱和度显著高于对照组（P〈0．01）。结论冻干重组人脑利钠肽可以有效改善急性失代偿性心力衰竭患者的心脏功能以及呼吸功能。

Objective To study the clinical effect of lyophilized recombinant human brain natrinretic peptide for the treatment of acute decompensated heart failure. Methods 90 patients with acute decompensated heart failure were ran- domly divided into observation group （ n = 45） and control group （ n = 45）. The patients in both groups received routine treatment. The patients in the observation group received lyophilized recombinant human brain natriuretic peptide intravenous injection. The patients in the control group received intravenous injection of nitroglycerin. Results Before treatment, the left ventricular end diastolic diameter （LVEDD） and left ventricular ejection fraction （LVEF） between the two groups showed no statistical difference （P 〉 0.05 ）. After treatment, the LVEDD in the observation group were signifi- cantly less than that in the control group （P 〈 0. O1 ）, while the LVEF in the observation group was significantly higher than that in the control group （P 〈 0.01 ）. Before treatment, the partial pressure of carbon dioxide in the arterial blood （ PaCO2 ）, time vital capacity （ TVC）, systolic blood pressure, and oxygen saturation were not statistically significant between the two groups （P 〉 0.05）. After treatment, the PaCO2 and systolic blood pressure were significantly lower in the observation group than in the control group （P 〈 0.01 ）. The TVC and oxygen saturation were significantly higher in the observation group than in the control group （P 〈 0.01 ）. Conclusion Lyophilized recombinant human brain natriuretic peptide can effectively improve the cardiac function and respiratory function in patients with acute decompensated heart failure.