前列地尔治疗重症心力衰竭并肾功能不全患者安全性及有效性观察  

Effectiveness and safety of alprostadil in the treatment of severe heart failure with renal insufifciency patients

作　　者：武琼[1] 赵明[1] 韩秀敏[1] 肖家旺[1] 陈锦如[1] 米沅[1] 

机构地区：[1]解放军沈阳军区总医院,110016

出　　处：《中国临床实用医学》2015年第3期21-24,共4页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目（2011225021）

摘　　要：目的：观察重症心衰合并肾功能不全患者在常规抗心衰、保肾治疗基础上应用前列地尔注射液的安全性及有效性。方法选择2013年11月至2014年10月期间沈阳军区总医院收治的重症心衰合并肾功能不全住院患者30例，将其随机分为对照组和治疗组，各15例。两组均给予心衰常规治疗及基础保肾治疗。治疗组在常规治疗基础上加用凯时10μg＋0.9%NaCl注射液100 ml缓慢静脉滴注，2次/d，连续用药7 d。分别记录用药当天、第3天、第7天肌酐、肌酐清除率、治疗前后氨基末端-脑利钠肽前体（NT-proBNP）和左室射血分数（LVEF）。结果两组患者心功能和肾功能均得到改善。NT-proBNP和肌酐均较入院时下降，但与对照组相比，治疗组患者NT-proBNP下降更为明显（P〈0.05），用药过程中个别患者出现轻微不良反应，但不影响治疗。结论（1）重症心衰合并肾功能不全患者在常规治疗基础上，加用小剂量前列地尔注射液对于患者心肾功能的改善是安全且有效的；（2）NT-proBNP可作为重症心衰患者危险分层的可靠标记物。Objective To observe effectiveness and safety of alprostadil in the treatment of severe heart failure with renal insufficiency patients on the basis of conventional therapy. Methods There were all 30 cases of severe heart failure with renal insufficiency patients whom were hospitalized in the General Hospital of Shenyang Military Area Command during 2013 November to 2014 October. They were randomly divided into treatment group（15cases） and control group（15cases）. Control group was given conventional therapy and treatment group received both conventional therapy and alprostadil therapy （using alprostadil 10 ug＋0.9%Sodium Chloride Injection100 ml,ivgtt,once time a day and,continuous application for 7 days. Collected serum creatinine,creatinine clearance rate,NT-proBNP and LVEF at first day,third day and seventh day. Also observed the adverse reactions during the application of alprostadil. Results After the treatment of conventional therapy,the symtoms and signs of the two groups patients were both improved .The Scr and NT-proBNP were significantly reduced（P〈0.05）. Compared with control group,the Ccr was significantly increased in treatment group,while it did not have statitical significance（P〉0.05）. There was no adverse reaction during alprostadil treatment. Conclusion Alprostadil is safe and effective in the treatment of severe heart failure with renal insufficiency patients. It can improve the function of kidney and heart in these patients. NT-proBNP can be used as a reliable marker for risk stratification in patients with severe heart failure.

关 键 词：前列地尔 心力衰竭 肾功能不全 心肾综合征 NT—proBNP 

分 类 号：R977.6[医药卫生—药品]