冻干重组人脑利钠肽治疗急性左心功能衰竭患者的临床观察

Clinical Observation of Freeze-dried Recombinant Human Brain Natriuretic Peptide in the Treatment of Acute Left Heart Failure

目的:观察冻干重组人脑利钠肽治疗急性左心功能衰竭的临床疗效及安全性。方法:将60例急性左心功能衰竭患者,按随机数字表法分为观察组和对照组,各30例。对照组患者给予吸氧、利尿、强心、扩张血管、控制心律失常及抑制心室重构等常规治疗;观察组患者在对照组基础上加用冻干重组人脑利钠肽注射液1.5μg/kg静脉推注,然后以0.007 5μg/(kg·min),ivgtt,72 h。观察两组患者临床疗效及治疗前后左心室舒张末期内径(LVDD)、左心室射血分数(LVEF)、肾上腺素(E)、去甲肾上腺素(NE)、肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平,并记录其不良反应。结果:观察组患者总有效率明显高于对照组(83.33%vs.60.00%),差异有统计学意义(P<0.05)。治疗前,两组患者LVDD、LVEF、E、NE、PRA、AngⅡ、ALD水平比较,差异无统计学意义(P>0.05);治疗后,两组患者上述指标均显著改善,且观察组改善程度显著优于对照组,差异均有统计学意义(P<0.05);两组患者均未见明显不良反应发生。结论:冻干重组人脑利钠肽治疗急性左心功能衰竭疗效显著,且安全性较好。

OBJECTIVE：To observe clinical efficacy and safety of freeze-dried recombinant human brain natriuretic peptide（rh-BNP）in the treatment of acute left heart failure. METHODS：60 patients with acute left ventricular failure were randomly divided into observation group and control group,with 30 cases in each group. Control group was given conventional treatment of oxygen inhalation,diuresis,cardiotonic,dilating the blood vessel,controlling arrhythmia and inhibiting ventricular remodeling;observation group was additionally given freeze-dried rh-BNP 1.5 μg/kg intravenously,maintaining at 0.007 5 μg/（kg·min）ivgtt for72 h on the basis of control group. Clinical efficacy of 2 groups were observed,and the levels of LVDD,LVEF,adrenalin（E）,noradrenalin（NE）,renin activity（PRA）,angiotensin Ⅱ（Ang Ⅱ）and aldosterone（ALD）were observed before and after treatment and ADR was recorded. RESULTS：Total effective rate of observation group was significantly higher than that of control group（83.33% vs. 60.00%）,with statistical significance（P〈0.05）. Before treatment,there was no statistical significance in the levels of LVDD,LVEF,E,NE,PRA,Ang Ⅱ and ALD between 2 groups（P〉0.05）;after treatments,above index of 2 groups were improved significantly,and the observation group was better than the control group,with statistical significance（P〈0.05）.No obvious ADR was found in 2 groups. CONCLUSIONS：rh-BNP shows obvious therapeutic efficacy and good safety in the treatment of acute left heart failure.