冻干重组人脑利钠肽治疗急性左心衰竭疗效观察  

Clinical efficacy of lyophilized recombinant human brain natriuretic peptide in the treatment of acute left ventricular failure

作　　者：胡碧江[1] 王薇[1] 何平[1] 丁毅鹏[1] 

机构地区：[1]海南省人民医院龙华急诊科,海南海口570102

出　　处：《海南医学》2013年第10期1416-1418,共3页Hainan Medical Journal

摘　　要：目的探讨冻干重组人脑利钠肽治疗急性左心衰竭的临床疗效。方法将86例急性左心衰竭患者采用随机数字表法分为治疗组和对照组各43例,两组均先给予标准的抗心衰基础治疗,治疗组在对照组基础上加用冻干重组人脑利钠肽(新活素),首次负荷剂量为1.5μg/kg,静脉注射,然后按0.01μg/(kg·min)剂量持续静脉泵入,连续用药72h,现察患者治疗前和治疗后1周的临床症状、心率、血压,测定血浆中氨基末端B型利钠肽前体(N-未端脑利钠肽前体、NT-proBNP)的浓度及左室射血分数(LVEF)情况。结果治疗组的总有效率(83.72%)高于对照组(60.47%),两组比较差异有统计学意义(P<0.05)。两组治疗前心率、血压、LVEF、NT-proBNP各项指标比较差异均无统计学意义(P>0.05);治疗组的心率、LVEF、NT-proBNP值治疗前后比较差异有统计学意义(P<0.01);两组治疗后NT-proBNP值、LVEF、心率均较治疗前有明显改善(P<0.001),但治疗组的NT-proBNP值、LVEF和心率治疗后与对照组相比较改善更加显著(P<0.001)。两组血压治疗前后比较差异均无统计学意义(P>0.05)。结论冻干重组人脑利钠肽治疗急性左心衰竭疗效显著,可降低血浆中NT-proBNP的浓度,使患者的心功能和血流动力学紊乱得到明显改善,安全性好。Objective To investigate the clinical efficacy of lyophilized recombinant human brain natfiuretic peptide in the treatment of acute left ventricular failure. Methods Eighty-six patients with acute left heart failure were randomly divided into the treatment group and the control group, with 43 patients in each group. The two groups were first given standard anti-heart failure treatment group, and the treatment group applied lyophilized recombinant human brain natriuretic peptid additionally, initially 1.5 μg/kg （loading dose） IV injection, followed by an IV infusionrate of 0.01 μg/（kg-min）, for 72 hours. The efficacy before treatment and one week after treatment were compared be- tween the two groups, including indicators of clinical symptoms, heart rate, blood pressure, plasma amino-terminal pro-B-type natriuretic peptide precursor （N-terminal pro-brain natriuretic peptide, NT-proBNP） concentration and left ventricular ejection fraction （LVEF）. Results The total effective rate in treatment group （83.72%） was significantly higher than that of the control group （60.47%）, P〈0.01. The heart rate, blood pressure, LVEF, NT-proBNP of the two groups before treatment showed no statistically significant difference （P〉0.05）. The difference in heart rate, LVEF, NT-proBNP values before and after treatment in treatment group were statistically significant （P〈0.001）. After treat- ment, NT-proBNP values, LVEF, heart rate were significantly improved in the two groups （P〈0.001） but the improve- ments in treatment group were more profound （P〈0.001）. The blood pressure in the two groups showed no statistically significant difference before and after treatment （P〉0.05）. Conclusion In the treatment of acute left ventricular fail- ure, lyophilized recombinant human brain natriuretic peptide has significant effect in reducing the plasma concentra- tion of NT-proBNP and improving cardiac function and hemodynamic disturbances.

关 键 词：冻干重组人脑利钠肽 急性左心衰竭 NT-PROBNP 

分 类 号：R541.6[医药卫生—心血管疾病]