重组人脑利钠肽在应激性心肌病并急性泵衰竭中的应用

Application of recombinant human brain natriuretic peptide in stress cardiomyopathy complicated acute left heart failure

目的:观察冻干重组人脑利钠肽(Lrh-BNP)治疗应激性心肌病(SCM)合并急性泵衰竭的临床疗效。方法:选择SCM合并急性泵衰竭患者23例,随机分为常规治疗组(10例,接受常规治疗)和Lrh-BNP组(13例,在常规治疗基础上加用Lrh-BNP)。观察比较两组患者临床症状体征、心功能变化,心脏彩超评估比较两组治疗前后左室射血分数(LVEF)、每搏输出量(SV)、心脏指数(CI)、充盈早期血流峰值速度/充盈晚期血流峰值速度(E/A),以及治疗的总有效率。结果:Lrh-BNP组总有效率显著高于常规治疗组(92.3%比80.0%,P<0.05)。治疗前,两组各项心功能指标无显著差异(P均>0.05);治疗后,与常规治疗组比较,Lrh-BNP组LVEF[(50.2±16.3)%比(59.4±14.1)%]、SV[(39.5±10.4)ml比(48.3±12.5)ml]、CI[(3.7±1.1)L·min^(-1)·m^(-2)比(4.6±1.4)L·min^(-1)·m^(-2)]、E/A[(1.0±0.5)比(1.3±0.7)]显著升高(P均<0.05)。结论:Lrh-BNP治疗应激性心肌病合并急性泵衰竭有明显疗效。

Objective：To observe therapeutic effect of lyophilized recombinant human brain natriuretic peptide（Lrh-BNP）on stress cardiomyopathy（SCM）complicated acute bump failure.Methods：A total of 23 patients with SCM complicated acute bump failure were randomly divided into routine treatment group（n=10,received routine treatment）and Lrh-BNP group（n=13,received Lrh-BNP based on routine treatment）.Clinical symptoms and signs,cardiac function ：left ventricular ejection fraction（LVEF）,stroke volume（SV）,cardiac index（CI）,peak early diastolic velocity/peak late diastolic velocity（E/A）assessed by echocardiography before and after treatment,and total effective rate were compared between two group.Results：Total effective rate of Lrh-BNP group was significantly higher than that of routine treatment group（92.3% vs.80.0%,P〈0.05）.There were no significant difference in cardiac function indexes between two groups before treatment（P〉0.05all）;after treatment,compared with routine treatment group,there were significant rise in LVEF[（50.2±16.3）% vs.（59.4±14.1）%],SV[（39.5±10.4）ml vs.（48.3±12.5）ml],CI[（3.7±1.1）L min^-1 m^-2 vs.（4.6±1.4）L min^-1 m^-2] and E/A[（1.0±0.5）vs.（1.3±0.7）]in Lrh-BNP group,P〈0.05 all.Conclusion：Lrh-BNP possesses significant therapeutic effect on stress cardiomyopathy complicated acute left heart failure.