新活素与硝普钠联合治疗慢性心力衰竭

A randomized parallel controlled study of lyophilized recombinant human brain natriuretic peptide and sodium nitroprusside in the treatment of chronic heart failure

【目的】研究新活素与硝普钠治疗慢性心力衰竭(chronic heart failure,CHF)的临床效果,旨在寻求至治疗CHF更佳的临床药物。【方法】采用随机平行对照方法,将2014年10月至2016年1月在我院心内科进行诊治的108例CHF患者分为观察组和对照组,每组54例。观察组静脉泵入新活素[负荷量1.5μg/kg,维持量0.01μg·(kg·min)^(-1)],对照组静脉泵入硝普钠[50~100μg/min]。观察比较两组临床疗效及治疗前后左室射血分数(left ventricular ejection fraction,LVEF)及N端脑钠肽前体N端脑钠肽激素原(N-terminal B-type natriuretic peptide,NT-proBNP)差值变化。【结果】两组患者治疗后显示,观察组总有效率90.7%(49/54),明显优于对照组总有效率68.5%(37/54)(P<0.05),差异有统计学意义,观察组治疗前后NT-proBNP差值及LVEF差值明显优于对照组(P<0.05),差异有统计学意义。【结论】新活素可以短期内明显改善慢性充血性心衰患者的临床症状体征、提高左心室射血分数,降低NT-proBNP、对改善心功能有积极作用。

【Objective】To explore the clinical efficacy of lyophilized recombinant human brain natriuretic peptide and sodium nitrate in the treatment of chronic heart failure and find better clinical therapeutic drugs for CHF.【Methods】 According to the randomized parallel controlled method, 108 patients with CHF in the department of cardiology of our hospital from Oct. 2014 to Jan. 2016 were selected and divided into observation group and control group（54 cases per group）. The patients in the observation group received intravenous infusion of lyophilized recombinant human brain natriuretic peptide. Those in the control group received intravenous infusion of sodium nitrate. The changes of clinical efficacy and related indicators were compared between the two groups.【Results】After the treatment, the total efficiency in the observation group（90.7%, 49/54） was significantly better than that in the control group（68.5.%, 37/54）（P〈0.05）. The difference was statistically significant. The difference of NT-proBNP and LVEF in the observation group before and after the treatment was more significant than that in the control group（P〈0.05）.【Conclusion】Lyophilized recombinant human brain natriuretic peptide can significantly improve the clinical symptoms and signs in patients with chronic congestive heart failure in a short term, increase left ventricular ejection fraction and reduce NT-proBNP. It has a positive effect on improving cardiac functions.