人脑利钠肽与硝普钠在治疗急性心肌梗死并急性心力衰竭中的疗效对比研究

Comparative research on recombinant human brain natriuretic peptide and sodium nitroprusside in treatment of acute myocardial infarction complicated with acute heart failure

目的对比研究硝普钠和重组人脑利钠肽(rh BNP)分别对急性心肌梗死(AMI)合并急性心力衰竭(AHF)的临床疗效。方法随机选择心功能三级并没有心源性休克、AMI并AHF的患者56例,随机分为A组(rh BNP组)和B组(硝普钠组),在静脉应用呋塞米针剂治疗心力衰竭和标准抗缺血治疗基础上,依次加用rh BNP和硝普钠,分别观察两组患者24小时液体出入量,72小时后左心室舒张末期内径(LVEDD)、血清脑钠肽(BNP)水平、左心室射血分数(LVEF)。结果 A组用药24小时后尿量及出入量差值明显高于B组,72小时后两组患者LVEDD及BNP水平均较前显著下降,LVEF均明显上升,但A组升高和降低的幅度均较B组高。结论相比硝普钠而言,rh BNP更能改善AMI合并AHF患者的血流动力学表现和临床症状,效果显著。

Object i ve To compare the clinical efficacy of recombinant human brain natriuretic peptide（rhBNP） and sodium nitroprusside（SNP） in acute myocardial infarction（AMI） complicated with acute heart failure（AHF）. Methods The study enrolled 56 AMI patients complicated with AHF but without cardiogenic shock, their cardiac functions were classified Killip III, and the patients were randomly divided into two groups： rhBNP group and SNP group. On the basis of standard anti-ischemic treatment and anti- heart failure treatment by intravenous injection of furosemide, the two groups were treated with rhBNP and SNP, respectively, The changes of liquid intake and output after 24 hours＇ treatment, blood brain natriuretic peptide（BNP）, left ventricular end-diastolic dimension（LVEDD）, left ventricular ejection fraction（LVEF） before treatment and after 72 hours＇ treatment were observed. Results Compared with SNP group, the urine volume and the different value between the intake and output increased significantly in rhBNP group after 24 hours＇ treatment. Compared with before treatment, the blood BNP and LVEDD were decreased significantly and the LVEF was increased significantly after 72 hours＇ treatment in both groups. Conc I us i on Compared witn SNP, rhBNP could significantly improve the hemodynamie and clinical symptoms in the patients witn AMI complicated witn AHF, and the clinical effects are exact.