重组人脑利钠肽治疗老年急性心肌梗死合并心衰的疗效和安全性  

Effectiveness and safety of recombinant human brain natriuretic peptide in aged patients with acute myocardial infarction complicated with heart failure

作　　者：蔡卫东[1] 李晓鲁[1] 毕延萍[1] 

机构地区：[1]山东大学附属千佛山医院急诊科,济南250014

出　　处：《山东大学学报（医学版）》2010年第10期92-94,共3页Journal of Shandong University:Health Sciences

摘　　要：目的探讨重组人脑利钠肽治疗老年急性心肌梗死合并左心功能衰竭的疗效及安全性。方法选取老年急性心肌梗死合并左心功能衰竭患者46例,随机分为两组,治疗组在常规治疗基础上静脉泵入重组人脑利钠肽（先以负荷剂量1.5~2.0μg/kg静推,再予维持剂量0.007 5~0.01μg/kg.min持续泵入）;对照组在常规治疗基础上静点硝酸甘油（起始剂量为5~10μg/min,每隔5~10min增加5~10μg/min,直至获满意效果）,共用3d。观察两组患者用药前后血压、心率、尿量及血氧饱和度变化,并测量左室射血分数（LVEF）、左室短轴缩短率（FS）、心脏指数（CI）、二尖瓣舒张期E峰和A峰的比值（E/A）。结果在降低血压、心率,增加尿量方面两组差异有统计学意义（P〈0.05）;治疗组用药后左室收缩指标（EF、CI）和舒张功能指数（E/F）较对照组明显改善（P〈0.05）;治疗组药物不良反应发生率9.1%,对照组41.7%,差异具有统计学意义（P〈0.05）。结论重组人脑利钠肽治疗老年急性心肌梗死合并左心功能衰竭疗效显著,安全性好,不良反应发生率低。Objective To study the clinical results of recombinant brain natriuretic peptide（rhBNP） in the treatment of acute myocardial infarction（AMI） complicated with heart failure in aged patients.Methods 46 aged patients with AMI complicated with heart failure were randomly divided into the rhBNP or control group.Besides routine therapy,the rhBNP group received rhBNP（1.5~2.0 μg/kg bolus intravenous injection followed by 0.007 5 μg/kg/min continuous infusion）,while the control group was treated with nitroglycerin（starting at 5~10 μg/min and increasing 5~10 μg/min each time till the clinical effective dose was reached）.Both drugs were administered for 3 days.The blood pressure,heart rate,total urine output,left ventricular ejection fraction（LVEF）,left ventricular fractional shortening（FS）,cardiac index（CI） and index of E/A were recorded before and after treatment.Results After the treatment,heart rate and blood pressure were significantly reduced and the total urine output was increased in the rhBNP group compared with the control group（P0.05）.The levels of index of left ventricular contraction（EF,CI） and relaxation functions（E/A）in the rhBNP group were higher than those in the control group（P0.05）.The adverse drug reactions were lower in the rhBNP group than that in the control group（9.1% vs 41.7%,P0.05）.Conclusion rhBNP is an efficient and safe agent in the treatment of aged patients with acute myocardial infarction complicated with heart failure.

关 键 词：重组人脑利钠肽 老年人 硝酸甘油 急性心肌梗死 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]