重组人脑利钠肽对感染性休克患者心功能及组织灌注的影响

Effects of rhBNP on cardiac function and tissue perfusion in patients with septic shock

目的:探讨重组人脑利钠肽(rh BNP)对感染性休克患者的心功能及组织灌注的影响。方法:将感染性休克合并心功能不全的125例患者随机分为2组,2组均按照6 h早期目标导向治疗及集束化抗感染治疗方案进行治疗。在此基础上实验组62例患者加用rh BNP治疗,比较2组的疗效。结果:治疗后24、48、72 h实验组血乳酸及proBNP水平、心脏指数较对照组显著改善(P<0.05或P<0.01);2组间心率、平均动脉压、血氧饱和度比较无明显差异(P>0.05)。实验组入住ICU天数明显少于对照组,1个月生存率明显高于对照组(P<0.05或P<0.01)。结论:感染性休克患者在常规治疗基础上加用rh BNP,能较早地改善其组织灌注及心功能,有利于改善患者的预后。

Objective： To explore the effects of recombinant human brain natriuretic peptide（ rhBNP） on cardiac function and tissue perfusion in patients with septic shock. Methods： 125 cases of septic shock complicated with heart failure were randomly divided into two groups. Both of them were given the therapies in accordance with the 6 h of early goal-directed therapy and bundle anti-infection treatment. Additionally,62 patients in the trial group were treated with rhBNP. The therapeutic effects were compared between the two groups. Results： The lactic acid level,pro-BNP level and cardiac index in the trial group 24 h,48 h and 72 h after treatment were significantly improved as compared with the control group（ P〈0. 05 or P〈0. 01）. There was no significant difference in the mean arterial pressure,heart rate and oxygen saturation between the two groups（ P〉0. 05）. The ICU stay was significantly shorter,and the one-month survival rate was significantly higher in the trial group than in the control group（ P〈0. 05 or P〈0. 01）. Conclusion： Additional use of rhBNP on the basis of routine treatment can improve the early tissue perfusion and cardiac function,and improve the prognosis of patients with septic shock.