新活素治疗顽固性心力衰竭临床疗效观察

Clinical efficacy of recombinant human brain natriuretic peptide in treatment of refractory heart failure

目的 观察新活素对顽固性心力衰竭的临床治疗疗效。方法 入选2009年4月~2013年6月在陕西省宝鸡市第六人民医院入院治疗的顽固性心力衰竭患者72例,根据患者入组顺序分为观察组（n=36）和对照组（n=36）,观察比较两组患者用药前及用药后72 h血压、血清氨基末端脑钠肽前体（NT-pro BNP）水平、左室射血分数（LVEF）、心率、左室舒张末期内径（LVEDd）变化以及药物的不良反应。结果 观察组用药72 h后改善顽固性心力衰竭的有效率明显高于对照组（86.1%vs.52.8%,P〈0.05）。与治疗前相比,治疗后两组心率均明显下降,观察组[（84.7±4.3）次/min vs.（80.8±2.7）次/min,P〈0.05];对照组[（85.5±3.0）次/min vs.（80.6±1.8）次/min]。治疗后观察组[（2843.4±611.3）ng/L vs.（1675.5±446.8）ng/L,P〈0.05]与对照组[（2782.0±688.3）ng/L vs.（1955.1±404.4）ng/L]NT-pro BNP水平均明显下降（P〈0.05）,观察组下降大于对照组（P〈0.05）。治疗后观察组[（37.6±7.9）%vs.（49.8±7.9）%]与对照组[（36.9±10.2）%vs.（45.0±9.0）%]LVEF均明显增加（P〈0.05）,且观察组LEVF升高大于对照组（P〈0.05）。两组在低血压发生率上无统计学差异（P〉0.05）。结论 新活素治疗顽固性心力衰竭具有较好的疗效,能明显改善患者的血流动力学参数,且无明显不良反应。

Objective To observe the clinical efficacy of recombinant human brain natriuretic peptide （rhBNP） in treatment of refi＇actory heart failure. Methods The patients with refractory heart failure （n=72） were chosen from Apr. 2009 to Jun. 2013, and divided into observation group and control group （each n=36）. The changes of blood pressure （BP）, N-terminal pro brain natriuretic peptide （NT-proBNP）, left ventricular ejection fi＇action （LVEF）, heart rate （HR） and LVEDd, and adverse reactions were observed in 2 groups before and after treatment for 72 h. Results After treatmeut for 72 h, the effective rate of ameliorating refi＇aetory heart failure was significantly higher in observation group than that in control group （86.1% vs. 52.8%, P〈0.05）. After treatment, HR decreased significantly in observation group [（84.7 ± 4.3） times/min vs. （80.8 ± 2.7） times/rain, P〈0.05] and in control group [（85.5 ±3.0） times/rain vs. （80.6±1.8） times/rain]. After treatment, the level of NT-proBNP decreased significantly in observation group [（2843.4 ± 611.3） ng/L vs. （1675.5± 446.8） ng/L, P〈0.05] and in control group [（2782.± 688.3） ng/L vs. （1955.1 ±404.4） ng/L, P〈0.05], which was more significant in observation group （P〈0.05）. After treatment, LVEF increased significantly in observation group [（37.6± 7.9）% vs. （49.8±7.9）%] and control group [（36.9 ±10.2）% vs. （45.0 ± 9.0）%, P〈0.05], which was more significant in observation group （P〈0.05）. There was no statistical diftisrence in incidence of hypotension between 2 groups （P〉0.05）. Conclusion The curative effect of rhBNP is good on refractory heart failure, and it can improve significantly hemodynamic parameters without obvious adverse reactions.