奈西立肽注射剂治疗急性心力衰竭的临床研究  

Clinical trial of nesiritide injection in the treatment of acute heart failure

作　　者：陈瑞娟 刘玉仁 郑永先 吴鹏 付斌 CHEN Rui-juan;LIU Yu- ren;ZHENG Yong - xian;WU - peng;FU Bin(Department of Emergency, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, Chin)

机构地区：[1]中南大学湘雅医学院附属海口医院急诊科,海口570208

出　　处：《中国临床药理学杂志》2018年第11期1273-1275,共3页The Chinese Journal of Clinical Pharmacology

基　　金：海南省卫生厅科研基金资助项目(2011-SWK-06-132)

摘　　要：目的比较奈西立肽注射剂和呋塞米注射液治疗急性心力衰竭的临床疗效及安全性。方法将90例急性心力衰竭患者随机分为对照组和试验组,每组45例。对照组予以呋塞米每次40 mg,静脉滴注,滴注速度每分钟不超过4 mg;试验组予以初始剂量2 mg·kg^(-1)奈西立肽,静脉滴注,之后调整为0.01mg·kg·min^(-1)持续静脉滴注。2组患者均治疗24 h。比较2组患者的临床疗效、血流动力学、脑钠肽(BNP)、肿瘤坏死因子样弱凋亡诱导物(TWEAK),以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为91.11%(41例/45例)和64.44%(29例/45例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的心输出量分别为(2.31±0.27)和(1.78±0.21)L·min^(-1),左心室射血分数分别为(57.30±4.87)%和(48.26±5.12)%,BNP分别为(251.31±47.53)和(361.96±61.12)pg·m L^(-1),TWEAK分别为(98.32±9.21)和(122.30±16.26)pg·m L^(-1),差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应主要有低血压、皮肤瘙痒和心动过速,对照组发生的药物不良反应主要有恶心呕吐、低血钾和轻度胃肠胀气。试验组和对照组的总药物不良反应发生率分别为13.33%和17.78%,差异无统计学意义(P>0.05)。结论奈西立肽注射剂治疗急性心力衰竭的临床效果显著,其能明显地改善患者的血流动力学和BNP,且有助于TWEAK的清除,且不增加药物不良反应的发生率。Objective To compare the clinical efficacy and safety of nesiritide injection and furosemide injection in the treatment of acute heart failure. Methods Ninety patients with acute heart failure were randomly divided into the control and treatment groups with 45 cases per group.Control group received furosemide 40 mg per time,intravenous injection with the drop speed ≤ 4 mg·min^（-1）. Treatment group was treated with the initial dose 2 mg · kg^（-1） nesiritide, then adjusted to 0. 01 mg·kg·min^（-1） for continuous intravenous drip. Two groups were treated for 24 h. The clinical efficacy,hemodynamics,brain natriuretic peptide（ BNP）, tumor necrosis factor like weak inducer of apoptosis（ TWEAK） and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 91. 11%（ 41 cases/45 cases） and 64. 44%（ 29 cases/45 cases） with significant difference（ P〈0. 05）. After treatment,the main indexes in treatment and control groups were compared： cardiac output were（ 2. 31 ± 0. 27） and（ 1. 78 ± 0. 21） L·min^（-1）,left ventricular ejection fractions were（ 57. 30 ± 4. 87） % and（ 48. 26 ± 5. 12） %, BNP were（ 251. 31 ± 47. 53） and（ 361. 96 ± 61. 12） pg·m L^（-1）,TWEAK were（ 98. 32 ± 9. 21） and（ 122. 30 ± 16. 26） pg·m L^（-1）,the differences were statistically significant（ all P〈0. 05）. Adverse drug reactions in treatment group were low blood pressure,itchy skin and tachycardia,which in control group were nausea and vomiting,low blood potassium and mild gastric distension.The total incidences of adverse drug reactions in treatment and control groups were 13. 33% and 17. 78% without significant difference（ P〉0. 05）. Conclusion Nesiritide injection has a definitive clinical efficacy in the treatment of acute heart failure,which can effectively improve hemodynamics and BNP,and help to clear TWEAK,without increasing the incidence of adverse drug reactions.

关 键 词：奈西立肽注射剂 呋塞米注射液 急性心力衰竭 安全性 

分 类 号：R972[医药卫生—药品]