重组人脑利钠肽治疗高龄心衰患者的疗效及安全性

Efficacy and safety of recombinant human brain natriuretic peptide in treatment of elderly patients with heart failure

目的评价重组人脑利钠肽(rh BNP)治疗高龄心衰患者的疗效及安全性。方法 108例年龄≥80岁的高龄心衰患者随机分为试验组(rh BNP治疗)和对照组(硝酸甘油治疗),每组54例。观察2组患者的临床疗效、心功能及血清NT-Pro BNP的变化。测量血压、心率、肾功,并对不良事件进行记录。结果 2组24 h液体出量无显著差异,72 h后试验组的呼吸困难和临床状况的改善显著优于对照组(P=0.027);2组治疗后1周LVEF值均升高,且试验组显著高于对照组(P=0.016);2组治疗后1周血清NT-Pro BNP水平均下降,且2组下降程度有显著差异(P=0.000);试验组24 h血清NT-Pro BNP水平较基线值明显下降(P=0.000);2组不良反应发生率比较无显著差异(P=0.721)。结论重组人脑利钠肽能明显改善高龄心衰患者的呼吸困难程度及全身临床状况,在改善心功能及降低血清BNP方面优于硝酸甘油,其安全性与硝酸甘油类似。

Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide（rh BNP） in the treatment of elderly patients with heart failure（HF）. Methods A total of 108 elderly patients aged more than 80 years old were randomly divided into experimental group（treated by rh BNP） and control group（treated by nitroglycerin）,with 54 patients in each group. The clinical efficacy,heart function and the changes of blood serum NT-Pro BNP were observed. Blood pressure,heart rate and kidney function were measured,and adverse events were recorded. Results There was no significant difference in urine output in the two groups within 24 hours. The improvement of dyspnea and clinical symptoms in the experimental group was superior to that in control group after72 hours（P = 0. 027）. The LVEF values in the two groups were both increased after one week of treatment and the LVEF value in the experimental group was higher than that in the control group（P =0. 016）. After one week treatment,the blood serum NT-Pro BNP decreased in the two groups,and there was significant difference in the decreasing degree in the two groups（P = 0. 000）. Blood serum NT-Pro BNP was decreased after 24 hours in experimental group than baseline value（P = 0. 000）.There was no significant difference between two groups in the adverse events（P = 0. 721）. Conclusion Recombinant human brain natriuretic peptide could improve dyspnea and clinical symptoms of elderly patients with HF. And it is superior to nitroglycerin in decreasing blood serum BNP and improving heart function. Meanwhile,rh BNP is as safe as nitroglycerin.