奈西立肽对高龄急性失代偿性心力衰竭患者心、肾相关指标的影响  

Influences of nesiritide on relevant cardiorenal indexes in senile patients with acute decompensated heart failure

作　　者：付士辉[1] 伊双艳[1] 朱兵[1] 刘源[1] 王亮[1] 叶平[1] 骆雷鸣[1] 

机构地区：[1]中国人民解放军总医院南楼心血管二科,北京100853

出　　处：《中国循证心血管医学杂志》2011年第5期347-350,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的评价奈西立肽对高龄急性失代偿性心力衰竭患者心肾相关指标的影响。方法入选80例高龄急性失代偿性心力衰竭患者,随机分为常规治疗组(n=40)和常规治疗+奈西立肽组(奈西立肽组,n=40)。两组均接受抗心力衰竭常规治疗,奈西立肽组在常规治疗的基础上增加奈西立肽0.5～1.0mg/d持续泵入,速度0.0075～0.015μg/(kg·min),时间10～15h,疗程13d。比较两组治疗前和治疗第4、8、14d氮端B型利钠钛前体(NT-proBNP)、肌钙蛋白I(cTnI)、血浆白蛋白水平、估算肾小球滤过率(eGFR-MDRD)、血压等心肾功能相关指标。结果治疗前和治疗第4、8d,两组cTnI差异无统计学意义(P均>0.05),但治疗第14d两组cTnI差异有统计学意义(P<0.05)。两组血浆白蛋白水平总差异有统计学意义(P<0.05),但两组间治疗前和治疗第14d,血浆白蛋白水平无统计学差异(P均>0.05);治疗第4、8d时奈西立肽组血浆白蛋白呈增高趋势,两组间差异有统计学意义(P均<0.05)。两组间NT-proBNP、肾小球滤过率和血压差异无统计学意义(P均>0.05)。结论奈西立肽降低急性失代偿性心力衰竭患者cTnI,增加血浆白蛋白水平,对肾小球滤过率和血压无明显影响,安全性良好。Objective To review the influences of nesiritide on relevant cardiorenal indexes in senile patients with acute decompensated heart failure.Methods The patients（n=80） with acute decompensated heart failure were chosen and randomly divided into the routine treatment group（routine group） and group with routine and nesiritide treatment（nesiritide group,each n=40）.The two groups were all given the routine treatment of against heart failure and nesiritide group was additionally given nesiritide（0.5 mg/d to 1.0 mg/d） at a rate of 0.0075 μg/（kg·min） to 0.015 μg/（kg·min） for 10~15 hours.A therapeutic course was 13 days.The levels of NT-proBNP,cTnI and plasma albumin were compared,and eGFR-MDRD and blood pressure were estimated in two groups before the treatment and on the 4th,8th and 14th day after the treatment respectively.Results Before the treatment and on the 4th and 8th day after the treatment,the difference in cTnI was not statistically significant between two groups（all P0.05）,but was significant on the 14th day（P0.05）.The total difference in the level of plasma albumin had statistical significance（P0.05）,but that was not statistically significant between two groups（all P0.05） before the treatment and on the 14th day after the treatment.On the 4th and 8th day,the level of plasma albumin showed an increase trend in nesiritide group and the difference between two groups was statistically significant（all P0.05）.The differences in the indexes of NT-proBNP,eGFR-MDRD and blood pressure had no statistical significance between two groups（all P0.05）.Conclusion Nesiritide can reduce cTnI level and increase the level of plasma albumin,and has no influences on eGFR-MDRD and blood pressure in the patients with acute decompensated heart failure,so it is very safe.

关 键 词：奈西立肽 高龄 急性失代偿性心力衰竭 心肾功能 

分 类 号：R541.61[医药卫生—心血管疾病]