不同剂量重组人脑钠肽对老年急性失代偿性心力衰竭伴肾功能不全患者心肾功能指标及安全性的影响  

Influence of different doses of recombinant human brain natriuretic peptide on cardiac and renal function and safety in elderly acute decompensated heart failure patients with renal insufficiency

作　　者：王艳[1] 袁艺[2] 淡雪川[1] WANG Yan;YUAN Yi;TAN Xue-chuan(Department of Cardiology,The Second People′s Hospital of Yibin City,Yibin,Sichuan 644000,China;Department of Traditional Chinese Medicine,The Second People′s Hospital of Yibin City,Yibin,Sichuan 644000, China)

机构地区：[1]四川省宜宾市第二人民医院心内科,四川宜宾644000 [2]宜宾市第二人民医院中医科,四川宜宾644000

出　　处：《岭南心血管病杂志》2019年第5期561-565,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨常规剂量和低剂量重组人脑钠肽(recombinant human brain natriuretic peptide,rhBNP)对老年急性失代偿性心力衰竭(acute decompensated heart failure,ADHF)伴肾功能不全患者心、肾功能指标及安全性的影响。方法选取四川省宜宾市第二人民医院2015年1月至2018年8月收治的老年ADHF伴肾功能不全患者共150例,以随机抽签法分为对照组(75例)和观察组(75例),分别在对症干预基础上给予常规剂量和低剂量rhBNP辅助治疗;比较两组患者近期疗效,治疗前后心脏功能指标水平、肾功能指标水平及不良反应发生率。结果两组患者近期疗效比较,差异无统计学意义(P>0.05);两组患者治疗后左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(leftventricular end-diastolic dimension,LVEDD)、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、平均动脉压(mean artery pressure,MAP)、心率(heartrate,HR)、肌酐(creatinine,Cr)、估算肾小球滤过率(evaluated glomerular filtration rate,eGFR)及胱抑素C(cystatin C,Cys C)组间比较,差异无统计学意义(P>0.05);同时观察组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论常规剂量和低剂量rhBNP辅助治疗老年ADHF伴肾功能不全患者在心、肾功能改善方面效果接近;但低剂量rhBNP应用有助于降低药物不良反应发生风险,提高治疗安全性。Objectives To investigate the influence of conventional and low doses of recombinant human brain natriuretic peptide(rhBNP)on cardiac and renal function and safety in elderly acute decompensated heart failure(ADHF) patients with renal insufficiency.Methods A total of 150 elderly ADHF patients with renal insufficiency were chosen from January 2015 to August 2018 in The Second People′s Hospital of Yibin City and randomly divided into two groups including control group(75 patients)with conventional doses of rhBNP and observation group(75 patients)with low doses of rhBNP on the basis of conventional intervention.Clinical effects for short-term,indexes of cardiac function and renal function before and after treatment and incidence of adverse reactions between the two groups were compared.Results There was no significant difference in clinical effect for short-term between the two groups(P>0.05).There were no significant differences of left ventricular ejection fraction(LVEF),left ventricular end-diastolic dimension (LVEDD),N-terminal pro-brain natriuretic peptide(NT-proBNP),mean artery pressure(MAP),heart rate(HR) creatinine(Cr),evaluated glomerular filtration rate(eGFR)and cystatin C(Cys C)after treatment between the two groups(P>0.05).Incidence of adverse reactions of observation group was significantly lower than that of control group (P<0.05).Conclusions Conventional and low doses of rhBNP in the treatment of elderly ADHF patients with renal insufficiency possesses the same clinical effects on improving cardiac and renal function;but low dose of rhBNP application can efficiently reduce the adverse drug reactions risk and increase the safety of treatment.

关 键 词：心力衰竭 脑钠肽 肾功能不全 

分 类 号：R541.6[医药卫生—心血管疾病]