重组人脑利钠肽联合硝普钠治疗急性失代偿性心力衰竭的疗效评价  

Therapeutic effect of combined rh-BNP and sodium nitroprusside on acute decompensated heart failure

作　　者：梁海青[1] 郭牧[1] 张云强[1] 贾志[1] 宋昱[1] 

机构地区：[1]泰达国际心血管病医院CCU,天津300457

出　　处：《中华老年心脑血管病杂志》2015年第8期801-804,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察国产重组人脑利钠肽（rh-BNP）联合硝普钠治疗急性失代偿性心力衰竭（ADHF）的疗效及安全性。方法选择ADHF住院患者200例,心功能（NYHA）Ⅲ~Ⅳ级,随机分为试验组（rh-BNP＋硝普钠治疗）100例,对照组（硝普钠治疗）100例,分别静脉滴注48h。观察给药前后血流动力学改变、临床症状、心脏超声变化,记录不良事件。结果与对照组比较,试验组给药1h后平均肺毛细血管楔压[MPCWP,（19.09±3.33）mm Hg（1mm Hg=0.133kPa）vs（24.62±5.15）mm Hg,P〈0.05]、平均肺动脉压[（26.71±2.92）mm Hg vs（35.67±4.22）mm Hg,P〈0.05]、心输出量[（3.57±0.53）L/min vs（3.15±0.40）L/min,P〈0.05]有显著差异。2组MPCWP和心输出量的差异持续至给药4h（P〈0.05）;试验组与对照组第1天（24h）总尿量比较有统计学差异[（2410.00±826.88）ml vs（2110.00±768.64）ml,P〈0.05];试验组全身临床症状变化比例在给药1h高于对照组（99.0%vs 82.0%,P〈0.05）,试验组较对照组LVEF明显升高（P〈0.05）。结论rh-BNP和硝普钠联合治疗ADHF能更快更显著改善患者的血流动力学指标,增加尿量,改善临床症状,提高LVEF,耐受性和安全性良好。Objective To observe the therapeutic effect and safety of rh-BNP＋sodium nitroprus- side on ADHF. Methods Two hundred ADHF hospitalized patients were randomly divided into rh-BNP＋sodium nitroprusside group （n= 100） and control group （n= 100） according to their NYHA. Changes in their hemodynamics, clinlcal symptoms, cardiac uhrasonography and adverse events were recorded before and after drug treatment. Results The MPCWP and MPAP were significantly lower while the cardiac output was significantly higher in rh-BNP＋sodium nitro- prusside group than in control group 1 h after drug treatment （19. 09±3.33 mm Hg vs 24.62± 5.15 mm Hg,26.71±2.92 mm Hg vs 35.67±4.22 mm Hg,3.57±0.53 L/min vs 3.15±0.40 L/ min,P〈0.05）. The 24 h total urine volume and ratio of systemic clinical symotoms were signifi- cantly higher in rh-BNP＋sodium nitroprusside group than in control group 1 h after drug treat- ment （2410.00±826.88 ml vs 2110.00±768.64 ml,P〈0.05;99.0% vs 82.0%,P〈0.05）. The LVEF was significantly higher in rh-BNP4-sodium nitroprusside group than in control group 1 h after drug treatment （P〈0.05）. Conclusion rh-BNP＋sodium nitroprusside improves the hemo- dynamic parameters, urine volume, clinical symptoms and LVEF more quickly and significantly than sodium nitroprusside in ADHF patients with a good tolerance and safety.

关 键 词：利钠肽 脑 硝普钠 心力衰竭 血流动力学 

分 类 号：R541.6[医药卫生—心血管疾病]