冻干重组人脑利钠肽联合曲美他嗪治疗缺血性心力衰竭的临床研究  

Clinical trial of lyophilized recombinant human brain natriuretic peptide combined with trimetazidine in the treatment of patients with chronic ischemic heart failure

作　　者：杨素芹[1] 吕宪民[1] 郭建华 刘文慧 赵天智 岳宵 张晓艳 YANG Su-qin;LV Xian-min;GUO Jian-hua;LIU Wen-hui;ZHAO Tian-zhi;YUE Xiao;ZHANG Xiao-yan(Department of Cardiology,Tangshan Workers＇ Hospital,Tangshan 063000,Hebei Province,China;Department of Neurosurgery,The Fourth Military Medical University Tangdou Hospital,Xi＇ an 710000,China;Department of Cardiology,First People＇s Hospital,Baoding 071000,Hebei Province,China;Department of Cardiology,First People＇s Hospital,Zunhua 064200,Hebei Province,China)

机构地区：[1]唐山市工人医院心内科,河北唐山063000 [2]中国人民解放军第四军医大学唐都医院神经外科,西安710000 [3]保定市第一人民医院心内科,河北保定071000 [4]遵化市第一人民医院心内科,河北遵化064200

出　　处：《中国临床药理学杂志》2018年第17期2052-2054,2058,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81200902);河北省科技成果推广课题基金资助项目(20171399);河北省科学技术成果基金资助项目(20161656)

摘　　要：目的研究冻干重组人脑利钠肽(L-rh BNP)联合曲美他嗪对慢性缺血性心力衰竭患者的血浆脑利钠肽(BNP)与高敏C反应蛋白(hs-CRP)水平的影响。方法将80例慢性缺血性心力衰竭患者随机分为2组,每组40例:试验组与对照组。对照组口服曲美他嗪20 mg,每天3次;试验组在对照组基础上用冻干重组人脑利钠肽,负荷剂量1.5μg·kg^(-1),维持剂量7.5 ng·kg^(-1)·min^(-1),治疗7 d。于治疗前后,用超声心动图测得心功能,用酶联免疫吸附试验测定患者血浆BNP与hs-CRP水平。观察2组的药物不良反应(ADR)。结果治疗后,试验组与对照组的左心室射血分数分别为(39.51±8.97)%,(34.87±11.38)%;这2组的每搏量分别为(38.4±8.40),(36.28±7.20)m L;这2组的血浆BNP水平分别为(157.00±29.20),(178.00±30.10)pg·m L^(-1);这2组的血浆hs-CRP水平分别为(5.35±1.95),(7.06±2.35)g·L^(-1),组间比较差异均有统计意义(均P<0.05)。对照组与试验组的ADR发生率分别为10.00%(4例/40例),7.50%(3例/40例),组间比较差异无统计学意义(P>0.05)。结论冻干重组人脑利钠肽联合曲美他嗪治疗慢性缺血性心力衰竭疗效可靠,安全性较高。Objective To investigate the effect and security of trimetazidine combined with lyophilized recombinant human brain natriuretic peptide（ L-rh BNP） in the treatment of patients with chronic ischemic heart failure（ CIHF）. Methods Patients with CIHF were randomly divided into 2 groups（ n = 40）. The patients of the control group were given oral trimetazidine,20 mg,tid; while those of the treatment group were given L-rh BNP on base of control group,with an initial loading dose of 1. 5 g·kg^（-1） and a continuous dose of 7. 5 ng·kg^（-1）·min^（-1） for 7 consecutive days. The cardiac function was detected by ultrasonic cardiogram.The serum brain natriuretic peptide（ BNP） and high-sensitivity C-reactive protein（ hs-CRP） level were detected by enzyme linked immunosorbent assaykits before and after treatment. The adverce drugs reaction（ ADR） was investigated. Results After treatment,the left ventricular ejection fraction of the treatment group and control group were（ 39. 51 ± 8. 97） % and（ 34. 87 ± 11. 38） %; the stroke volume in 2 groups were（ 38. 4 ± 8. 40）,（ 36. 28 ± 7. 20） m L; the plasma BNP levels were（ 157. 00 ± 29. 20）,（ 178. 00 ± 30. 10）pg·m L^（-1）; the plasma hs-CRP levels in 2 groups were（ 5. 35 ± 1. 95）,（ 7. 06 ± 2. 35） g·L^（-1）,the difference of the factors between 2 groups had statistical significance（ all P 〈0. 05）. The incidence of ADR of the treatment group and the control group were respectively 7. 50%（ 3 cases/40 cases） and 10. 00%（ 4 cases/40 cases）,there was no significant difference between 2 groups（ P 〉0. 05）. Conclusion L-rh BNP combined with trimetazidine has certain effect and high security in the treatment of CIHF.

关 键 词：冻干重组人脑利钠肽 曲美他嗪 慢性缺血性心力衰竭 脑利钠肽 高敏C反应蛋白 

分 类 号：R972.1[医药卫生—药品]