探讨冻干重组人B型脑利钠肽对顽固性心力衰竭患者肾功能的影响

Effects of freeze-dried recombinant human B-type brain natriuretic peptide on renal function in patients with refractory heart failure

目的探讨冻干重组人B型脑利钠肽(rh-BNP)对顽固性心力衰竭(RHF)患者肾功能的影响。方法回顾性分析该院心内科重症监护室2016年9月至2018年1月收治的162例RHF患者的临床资料,根据是否应用rh-BNP分为观察组(n=83)和对照组(n=79)。对照组常规治疗;观察组在常规治疗的基础上,给予rh-BNP治疗。对两组患者治疗前及治疗后1、3、7 d的肾功能、心功能和炎症相关指标进行比较,以及给药30 d后随访评价肾功能指标。结果观察组患者治疗后3 d尿量较对照组明显增加,组间比较差异有统计学意义(P<0.05)。两组患者治疗后3 d血尿素氮(BUN)、血肌酐(SCr)呈升高趋势,组间比较差异无统计学意义(P>0.05);随着给药时间延长BUN、SCr呈下降趋势,与对照组比较,观察组患者BUN、SCr水平于治疗后7、30 d均明显下降,组间比较差异均有统计学意义(P<0.05),且治疗后30 d的BUN、SCr水平下降更明显。观察组患者治疗后30 d BUN、SCr水平较治疗前明显下降,差异有统计学意义(P<0.05)。结论冻干rh-BNP对RHF患者的肾功能具有一定保护作用,可明显改善患者的心功能,降低C反应蛋白(CRP)水平,改善患者预后。

Objective To explore the effect of freeze-dried recombinant human B-type brain natriuretic peptide(rh-BNP)on renal function in patients with refractory heart failure(RHF).Methods A retrospective analysis of clinical data from 162 patients with RHF in the coronary care unit(CCU)was made in the First Affiliated Hospital of Zhengzhou University from September 2016 to January 2018.According to whether rh-BNP was used,the patients were divided into two groups:the observation group(n=83)and the control group(n=79).The control group received reutine treatment.On the basis of routine treatment,the observation group was given rh-BNP.The indexes of renal function,cardiac function and inflammation factors were monitored before treatment and 1,3,7 days after treatment.The indexes of renal function were evaluated 30 days after treatment.Results Compared with the control group,the urine volume in the observation group increased significantly at the 3rd day after treatment,and the difference between the two groups was statistically significant(P<0.05).During the period,the blood urea nitrogen(BUN)and the serum creatinine(SCr)showed an increasing trend,but there was no statistical difference between the two groups(P>0.05).With the prolongation of administration time,the BUN and SCr tended to decline.Compared with the control group,BUN and SCr of patients in the observation group decreased significantly at 7,30 days after treatment,and the differences were statistically significant(P<0.05).After 30 days of treatment,BUN and SCr decreased more significantly.BUN and SCr of the two groups decreased significantly than those of the former 30 days after treatment(P<0.05).Conclusion Freeze-dried rh-BNP has a protective effect on renal function in patients with RHF,and can significantly improve the cardiac function,reduce the level of C-reactive protein(CRP)and improve the prognosis of patients.