重组人脑利钠肽介导氢氯噻嗪、氯沙坦和美托洛尔治疗充血性心力衰竭的疗效评价  

Curative effect evaluation of recombinant human brain natriuretic peptide guided hydrochlorothiazide,lorsartan and metoprolol in the treatment of congestive heart failure

作　　者：林惠文[1] 陈凤莲[1] 曾惠洁[1] 

机构地区：[1]广东省江门市中心医院急诊科,529070

出　　处：《中国实用医药》2014年第32期1-3,共3页China Practical Medicine

摘　　要：目的探讨重组人脑利钠肽(rh BNP)介导下治疗充血性心力衰竭(CHF)患者的疗效、安全性及短期预后。方法 86例CHF急性发作期患者随机分为rh BNP组(42例)及常规组(44例),常规组患者使用氢氯噻嗪、氯沙坦和美托洛尔等常规药物治疗,rh BNP组在常规组的基础上,静脉注射rh BNP。观察两组治疗前后的临床疗效、血浆N端脑钠肽前体(NT-pro BNP)浓度、血肌酐清除率及出院后患者主要心血管事件发生率的差异。结果与治疗前比较,两组血浆NT-pro BNP水平均明显降低,且rh BNP组下降更为显著(P<0.05);基础肾功能异常的CHF患者,使用rh BNP治疗后,血肌酐清除率改善程度明显优于使用常规治疗方案的患者(P<0.05)。同时,rh BNP组临床疗效评价总有效率92.86%,显著高于常规组的总有效率68.18%(P<0.05);治疗后1年内,rh BNP组总心血管不良事件发生率为9.52%,显著低于常规组34.09%(P<0.01)。结论 rh BNP介导下治疗CHF具有良好的临床疗效,且可以改善肾功能及降低不良心血管事件的发生率,安全性较高。Objective To investigate the curative effect, safety and short-term prognosis of recombinant human brain natriuretic peptide （rhBNP） guided therapy in the treatment of congestive heart failure （CHF）. Methods A total of 86 cases in acute attack stage of CHF were randomly divided into rhBNP group （n=42） and conventional group （n=44）. The conventional group received conventional drug treatment, such as hydrochlorothiazide, lorsartan and metoprolol, and the The rhBNP group received additional rhBNP through intravenous injection. The changes of curative effects, concentration of plasma N terminal pro-brain natriuretic peptide （NT-proBNP）, clearance rate of serum creatinine and incidences of post-discharge major adverse cardiac event of the two groups were all observed. Results Compared with initial data before treatment, concentrations of plasma NT-proBNP in both two group were significantly reduced, while the change in the rhBNP group was more obvious （P〈0.05）. Among the CHF patients with renal dysfunction, the change of clearance rate of serum creatinine after rhBNP treatment was much better than the conventional treatment （P〈0.05）. The total effective rate of the rhBNP group was 92.86%, which was higher than 68.18%of the conventional group （P〈0.05）. Within 1 year after the treatment, the incidence of major adverse cardiac event of the rhBNP group was 9.52%, which was obviously lower than 34.09%of the conventional group （P〈0.01）. Conclusion The rhBNP guided therapy in the treatment of CHF has good curative effect and high safety, and it can improve renal function and reduce incidence of major adverse cardiac event.

关 键 词：充血性心力衰竭 重组人脑利钠肽 肾功能 疗效 

分 类 号：R541.6[医药卫生—心血管疾病]