重组人脑利钠肽治疗老年急性冠脉综合征致急性心力衰竭的临床观察

Clinical study of recombinant human brain natriuretic peptide in patients with acute heart failure caused by senile acute coronary syndrome

目的：观察重组人脑利钠肽（ rhBNP）治疗老年急性脉综合征（ACS）致急性心力衰竭的临床疗效及安全性。方法选择2012年3月-2013年5月收入院的老年 ACS 患者108例，在常规使用 ACS 的治疗基础上加用rhBNP，连用3-5d；测定治疗前和停止静脉注射4h 后血浆 BNP 水平、心率（HR）、左室射血分数（LVEF）、左房内径（LAD）、血清肌酐（SCr）、收缩压（SBP）等指标，比较 rhBNP 治疗前后上述指标的变化及观察安全性。结果静脉注射rhBNP 后患者血浆 BNP、HR、LVEF、LAD、SCr 及 SBP 与治疗前相比显著改善，差异有统计学意义（P ﹤0.05）。治疗期间无不良反应发生。结论 rhBNP 静脉注射治疗老年 ACS 致急性心力衰竭安全有效；缩短了住院时间，降低了住院成本。值得临床推广应用。

Objective To evaluate the clinical efficacy and safety of infusion recombinant human brain natriuretic peptide（rhBNP）in patients with acute heart failure caused by senile acute coronary syndrome（ ACS）. Methods From march 2012 to may 2013,108 cases of senile ACS patients admitted to hospital were added with rhBNP based on conventional therapy in ACS for three to five days;then measured the level of plasma BNP、heart rate（HR）、left ventricular ejection fraction （LVEF）、Left atrial diameter（LAD）、serum creatinine（Scr）、systolic blood pressure（SBP）and other indicators before treat-ment and after intravenous infusion rhBNP for 4 hours and compared the change of above indicators before and after the treat-ment of intravenous infusion rhBNP and evaluate its safety. Results After intravenous infusion of rhBNP,the plasma BNP、heart rate、LVEF、LAD and Scr of the patients were significantly improved compared with the situation before treatment,the differences were statistically significant（P ﹤ 0. 05）. And there were no adverse events. Conclusion The intravenous infusion of rhBNP in treating patients with acute heart failure caused by senile ACS was effective and safe;the duration of hospitalization was shortened and hospitalization cost was reduced. It is worthy of clinical application.