低剂量重组人脑利钠肽治疗心肌梗死后心力衰竭的临床研究  

Effect of Low-dose Recombinant form of Human Brain Natriuretic Peptide in Heart Failure Patients following Acute Myocardial Infarction

作　　者：关信民[1] 赵强[1] 李彪[1] 陈希伟[1] 吴同果[1] 

机构地区：[1]广州市红十字会医院心内科,广东广州510220

出　　处：《中国医药指南》2011年第20期179-181,共3页Guide of China Medicine

基　　金：2009年度广州市医药卫生科技一般引导项目立项项目(项目编号:2009-YB-043)

摘　　要：目的探讨低剂量重组人脑利钠肽(rhBNP)治疗急性心肌梗死后心力衰竭患者的有效性和安全性。方法 40例急性心肌梗死(AMI)心力衰竭患者随机分为低剂量rhBNP组[不用负荷剂量,只用维持剂量0.0075μg/(kg?min)]和硝酸甘油(NTG)组,每组各20例。比较两组治疗前后血压、心率、尿量、呼吸困难程度,血清钠、钾、肌酐、氮末端前体脑钠肽(NT-proBNP)水平的变化。结果与NTG组相比,rhBNP组患者心率下降的更明显(P<0.05),尿量显著增多(P<0.01),呼吸困难的程度显著改善(P<0.01),且低血压的发生率较低(P=0.048)。治疗24h后rhBNP组血NT-proBNP水平下降的更显著(P<0.01)。与治疗前比较r,hBNP组血肌酐水平无明显变化(P>0.05),但NTG组有升高的趋势(P=0.24)。结论与NTG相比,低剂量rhBNP能更有效的改善急性心肌梗死后心力衰竭患者的血流动力学及呼吸困难的症状,对肾功能没有不利的影响。Objective To investigate the efficacy and safety of low-dose recombinant form of human brain rtatriurotic peptide（rhBN-P） in patients with heart failure following acute myocardial infarction. Methods Forty patients were randomized into rbBNP （maintenance dose 0.0075μg/kg/min） and nitroglycerin（NTG） group. The level of blood pressure, heart rate, urine volume and dyspnea were analyzed in the two groups before and after drug administration. Blood concentrations of sodium, potassium, creatinine and N-terminal prohormone BNP（NT-proBNP） were also measured before and after the course of therapy. Results Compared with the NTG group, the rhBNP group had a greater heart rate reduetiun （P〈0.05）, higher urine volume （P〈0.01）, and more significant alleviation in dyspnea （P〈0.01）. The prevalence of hypotension in the rhBNP group was lower than in the NTG group （P---0.048）. The rhBNP group bad a greater reduction in serum NT-proBNP compared with the NTG group （P〈0.01）. The serum creatinine in the NTG group intended to increase（P=0.24）, whereas it remained unchanged in the rhBNP group（P〉0.05）. Conclusion Low-dose nesiritide is more effective in improving the clinical symptoms in heart failure patients following acute myocardial infarction, and had no adverse effect on renal function.

关 键 词：重组人脑利钠肽 心力衰竭 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]