重组人脑利钠肽治疗急性失代偿性心力衰竭的临床效果及安全性研究

Clinical effect and safety of recombinant human brain natriuretic peptide in the treatment of acute decompensated heart failure

目的探讨重组人脑利钠肽治疗急性失代偿性心力衰竭(ADHF)的临床效果及安全性。方法选取2012年1月—2014年8月新化县人民医院收治的ADHF患者84例,随机分为对照组40例与观察组44例。对照组患者给予硝酸甘油治疗,观察组患者给予重组人脑利钠肽治疗,两组患者均治疗72h。比较两组患者治疗前后射血分数(EF)和肺动脉压(PAP)、呼吸困难与全身临床症状改善情况、总液体出入量、呋塞米用量、不良事件发生情况。结果治疗前两组患者EF、PAP比较,差异无统计学意义(P>0.05);治疗后观察组EF高于对照组,PAP低于对照组,差异有统计学意义(P<0.05);治疗后观察组EF高于治疗前,PAP低于治疗前,差异有统计学意义(P<0.05);治疗后对照组EF、PAP与治疗前比较,差异无统计学意义(P>0.05)。治疗后观察组患者呼吸困难改善总有效率高于对照组,全身症状改善总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者总液体出入量、不良事件发生率比较,差异无统计学意义(P>0.05)。观察组患者呋塞米用量少于对照组,差异有统计学意义(P<0.05)。结论重组人脑利钠肽治疗ADHF的临床效果确切,能改善患者的血流动力学指标及临床症状,其安全性与硝酸甘油类似。

Objective To study the clinical effect and safety of recombinant human brain natriuretic peptide in the treatment of acute decompensated heart failure( ADHF). Methods A total of 84 ADHF patients from January 2012 to August2014 in the People's Hospital of Xinhua were randomly divided into control group( 40 cases) and treatment group( 44 cases).The control group were treated with nitroglycerin,the treatment group were treated with recombinant human brain natriuretic peptide,treatment for 72 h. The ejection fraction,pulmonary artery pressure,dyspnea,the improvement of clinical symptoms,total fluid intake,furosemide dosage and the adverse events before and after treatment were compared. Results There were no statistically significant differences in ejection fraction and pulmonary artery pressure between the two groups before treatment( P> 0. 05),after treatment,the ejection fraction of treatment group was higher than the control group,pulmonary artery pressure was lower than the control group( P < 0. 05). After treatment,the ejection fraction of treatment group was higher than before treatment,pulmonary artery pressure was lower than before treatment( P < 0. 05). But there were no statistically significant differences in ejection fraction and pulmonary artery pressure between before and after treatment in the control group( P >0. 05). The total effect rate of dyspnea and the improvement of clinical symptoms rate of treatment group were higher than the control group( P < 0. 05). However,the total fluid intake,occurrence of adverse events between the two groups showed no significant differences( P > 0. 05),and the furosemide dosage of treatment group was less than the control group( P < 0. 05).Conclusion The recombinant human brain natriuretic peptide has an exact effect which was similar as nitroglycerin in the treatment of ADHF,it can improve the hemodynamics and clinical symptoms.