厄贝沙坦联合重组人脑利钠肽治疗充血性心力衰竭的临床疗效及安全性评价

Clinical study of irbesartan combined with recombinant human brain natriuretic peptide in the treatment of congestive heart failure

目的评价厄贝沙坦联合重组人脑利钠肽治疗充血性心力衰竭的临床疗效及安全性。方法将66例充血性心力衰竭患者随机分为试验组34例和对照组32例。对照组给予厄贝沙坦150 mg·d-1,口服1个月;试验组在对照组用药的基础上,给予人脑利钠肽首剂1.5μg·kg-1静脉冲击,后以7.5ng·kg-1·min-1的速度连续静脉滴注,应用1周。治疗1个月后,比较2组患者的有效率、血清生化指标及不良反应发生率。结果治疗后,试验组总有效率显著高于对照组(88.24%vs 68.75%,P<0.05);2组患者血清去甲肾上腺素、内皮素-1和抗利尿激素较治疗前显著降低(P<0.05),而试验组治疗后上述指标均显著低于对照组(P<0.05)。2组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论厄贝沙坦联合重组人脑利钠肽可显著提高充血性心力衰竭患者的临床疗效,改善血清学指标,且不增加不良反应的发生率。

Objective To explore the clinical effects and safety of irbesartan combined with recombinant human brain natriuretic peptide on congestive heart failure.Methods A total of 66 patients with congestive heart failure were randomly divided into control group（n = 32） and experiment group（n = 34）.Patients in the control group were treated with irbesartan 150 mg·d^-1,po for a month and patients in the experiment were treated with recombinant human brain natriuretic peptide 1.5μg·kg^-1by intravenous drip followed by 7.5 ng·kg-1·min^-1by intravenous drip on the basis of control group.After one month treatment,the data of total efficacy,serum index and adverse reactions between the two groups were compared.Results The total effective rate was68.75% and 88.24% in the control and experiment group,which showed a higher rate in the experiment group with statistical difference（P〈0.05）.The serumLevel of norepinephrine（NE）,endothelin 1（ET-1）,and anti-diuretic hormone（ADH） were decreased in both groups after treatment,while the experiment group showed a much lower level than those in the control group（P〈0.05）.The adverse reactions between the two groups were not statistically different（P〉0.05）.Conclusion Irbesartan combined with recombinant human brain natriuretic peptide can increase the total efficacy of patients withcongestive heart failure,improve serum indexes and not increase adverse reactions.