冻干重组人脑利钠肽和心脉隆注射液对顽固性心力衰竭的疗效对比  

Comparative study of lyophilized recombinant human brain natriuretic peptide and Xinmailong injection in the treatment of refractory heart failure

作　　者：刘小伟[1,2] 刘新林[2] 杨国红[2] 周邠玮[2] 毕莹[2] 赵季红[2] 姜铁民[2] 

机构地区：[1]天津中医药大学,天津300193 [2]武警后勤学院附属医院心脏医院,天津300162

出　　处：《武警后勤学院学报（医学版）》2016年第4期281-284,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】观察冻干重组人脑利钠肽(recombinant human brain natriuretic peptide,rh BNP)及心脉隆注射液治疗顽固性心力衰竭患者(refractory heart failure,RHF)的临床疗效,指导临床用药。【方法】RHF患者33例经常规治疗后心衰症状无缓解,随机分为冻干重组人脑利钠肽治疗组(A组)17例和心脉隆注射液治疗组(B组)16例,观察两组患者用药前、用药3、5 d后临床有效率、N末端脑钠肽前体(NT-pro BNP)、左室射血分数(left ventricular ejection fraction,LVEF)及6 min步行距离,评价两种药物的临床疗效。【结果】(1)两组的总体有效率:治疗3 d后,分别为64.7%、25%(P<0.05);治疗5 d后,分别为88.2%、87.5%(P>0.05)。(2)NT-pro BNP水平、LVEF值、6 min步行距离:治疗3 d后,A组与B组比较,差异有统计学意义(P<0.05),与治疗前比较,差异均有统计学意义(P<0.05);治疗5 d后,两组差异无统计学意义(P>0.05),两组NT-pro BNP水平、LVEF值、6 min步行距离与治疗前比较,差异有统计学意义(P<0.05)。【结论】RHF患者在常规治疗基础上加用rh BNP或心脉隆注射液均能提高患者的心功能,但rh BNP显效快,提示慢性心衰患者急性期或是急性心衰患者可首选rh BNP,在用药5 d后,两种药物疗效相当。【Objective】To observe the clinical therapeutic efficacy of lyophilized recombinant human brain natriuretic peptide（rh BNP）and Xinmailong injection on refractory heart failure（RHF） and guide clinical medication.【Methods】A total of 33 RHF patients whose symptoms were not significantly alleviated after routine therapy were randomly divided into rh BNP group（A group, 17 cases） and Xinmailong injection group（B group, 16 cases）. The clinical efficiency, NT-Pro BNP level, left ventricular ejection fraction（LVEF） and 6-min walking distance of the two groups were respectively determined before the treatment, on the 3rd and 5th days after the therapy.Then the clinical efficacy of the two drugs was evaluated.【Results】（1） The overall efficiency of the two groups was respectively 64.7%and 25% on the 3rd day after the therapy（P〈0.05）, as well as 88.2% and 87.5% on the 5th day after the treatment（P〉0.05）.（2） The NT-Pro BNP level, LVEF and 6-min walking distance were significantly different between A group and B group on the 3rd day after the therapy（P〈0.05）, and all the parameters of the two groups were significantly different on the 3rd day after the therapy compared with those before the treatment（P〈0.05）. There was no markedly difference between the two groups on the 5th day after the treatment（P〉0.05）, but all the parameters of the two groups were significantly improved on the 5th day after the therapy compared with those before the treatment（P〈0.05）.【Conclusions】Based on routine therapy,rh BNP and Xinmailong injection can both improve cardiac function and relieve symptoms in RHF patients while rh BNP takes effect faster than Xinmailong injection. It indicates that rh BNP can be the first choice in acute phase of chronic heart failure or acute heart failure,while the efficacy of the two drugs makes no difference 5 days after the therapy.

关 键 词：冻干重组人脑利钠肽 心脉隆 顽固性心力衰竭 疗效 

分 类 号：R972[医药卫生—药品]