重组人B型脑钠肽治疗急性失代偿性心衰的临床研究  

Clinical Control Study of Treatment for Chinese Patients with Acute Decompensated Heart Failure with Lyophilized Recombinant Human Brain Natriuretic Peptide Made in China

作　　者：何华[1] 贾平[1] 韩福生[1] 李勇[1] 张铭[1] 崔松[1] 马临安[1] 

机构地区：[1]首都医科大学附属北京安贞医院急诊心内科,北京100029

出　　处：《中国医刊》2010年第7期33-34,共2页Chinese Journal of Medicine

摘　　要：目的探讨重组人B型脑钠肽用于急性失代偿性心衰(ADHF)的疗效、安全性、适应证及不良反应情况。方法对照组45例给予标准常规治疗,包括扩管、利尿、抗感染、病因治疗;治疗组46例在常规治疗基础上(但不使用利尿剂)加用重组人B型脑钠肽,首次负荷剂量1.5μg/kg,然后以0.0075μg/(kg·min)连续静脉滴注72小时。观察两组用药前后临床症状、体征的变化,同时记录两组血压、尿量、超声心动图LVEF、CI变化,并观察血、尿常规、肝、肾功能的变化。结果两组基线特征差异无显著性,经治疗后,治疗组心率、血压显著下降,而24小时尿量显著增加,LVEF、CI亦较对照组改善更多,两组间各项临床指标差异有显著性;治疗组呼吸困难明显减轻,总有效率91.3%,对照组为77.8%。结论重组人B型脑钠肽可明显改善患者临床症状和全身状况,短期临床疗效优于对照组,不良反应少,但使用时应严格掌握适应证,并按照推荐剂量,以确保患者的用药安全。Objective To investigate therapeutic effect, safety, indication and adverse effects in treatment for chinese patients with acute deeompensated heart failure （ADHF） with Lyophilized Recombinant Human Brain Natriuretic Peptide （rh-BNP） made in China. Methods Selective patients with ADHF were divided randomly into control group （n = 45） and treatment group （n = 46） ： control group received typical conventional therapy, including enlarging blood vessel, diuresis, anti-infection, etilogical treatment, etc; and treatment group received Lyophilized rh-BNP made in China on the basis of conventional therapy （except diuresis） with priming loading dose of 1.5p.g/kg iv and following dose of 0.0075μg/（ kg·min） for continuous 72 hours by ivgtt. Then the changes of clinical symptoms and physical signs in both groups were observed, and the changes of blood pressure, urinary volume during 24h, left ventricular ejection fraction, cardiac index, blood routine, urine routine, liver function, renal function in both groups before and after treatment were recorded. Results The differences in baseline characteristics between two groups weren＇t significant. Heart rate and blood pressure was decreased significantly, and urinary volume during 24h, left ventricular ejection fraction, cardiac index increased significantly in treatment group;dyspnea was abated in relieved and total effective rate was 91.3% in treatment group and that was 77.8% in control group. Conclusion Lyophilized rh-BNP made in China could improve clinical symptoms and physical condition of the Chinese patients with ADHF significantly, and have an advantage for conventional therapy on short-term therapeutic effect, and bring about less and slight adverse effects;however, indications and doses of the drug should be grasped exactly during using it in order to ensure safety.

关 键 词：重组人B型脑钠肽 急性失代偿性心衰 对照研究 

分 类 号：R575.5[医药卫生—消化系统]