重组人脑利钠肽治疗急性心力衰竭疗效观察  

Observation on efficacy of recombinant human brain natriuretic peptide on acute heart failure

作　　者：吴代琴 郭海俊 廖付军 李屏 程友琴[2] WU Dai-qin;GUO Hai-jun;LIAO Fu-jun(Department of Internal Medicine-Cardiovascular,Guizhou 550000,China)

机构地区：[1]贵州医科大学附属医院心内科,550000 [2]北京解放军总医院心内科,100000

出　　处：《中国实用医药》2020年第11期8-10,共3页China Practical Medicine

摘　　要：目的观察重组人脑利钠肽(rhBNP)治疗急性心力衰竭的疗效。方法148例急性心力衰竭住院患者,以随机数字表法分为rhBNP组和硝酸甘油组,各74例。rhBNP组在常规治疗的基础上加用rhBNP治疗,硝酸甘油组在常规治疗的基础上加用硝酸甘油治疗。比较两组患者用药后呼吸困难状况及整体临床状况,用药前与用药后24 h血流动力学参数差值,用药前与用药后72 h室性心律失常情况。结果rhBNP组用药后0.5、6、24 h的呼吸困难状况及整体临床状况均优于硝酸甘油组,差异均有统计学意义(P<0.05)。硝酸甘油组用药前与用药后24 h的左室射血分数、肺动脉压、肺毛细血管楔压(PWCP)、收缩压差值分别为(+0.36±3.68)%、(+1.22±2.03)mm Hg(1 mm Hg=0.133 kPa)、(-7.68±1.06)mm Hg、(+0.21±5.03)mm Hg,rhBNP组分别为(+4.07±1.25)%、(-2.87±1.60)mm Hg、(-4.21±1.03)mm Hg、(-3.53±1.44)mm Hg。rhBNP组用药后24 h左室射血分数的增加程度,肺动脉压、PCWP、收缩压的降低程度均优于硝酸甘油组,差异均有统计学意义(P<0.05)。rhBNP组用药后72 h心率降低,室性早搏、配对室性早搏、阵发性室性心动过速发作次数减少均优于硝酸甘油组,差异均有统计学意义(P<0.05)。结论rhBNP能明显改善急性心力衰竭患者呼吸困难和整体临床状况,疗效确切。Objective To observe the efficacy of recombinant human brain natriuretic peptide(rhBNP)on acute heart failure.Methods A total of 148 acute heart failure patients were divided into rhBNP group and nitroglycerin group by random number table method,with 74 cases in each group.rhBNP group was treated by rhBNP on the basis of conventional therapy,and nitroglycerin group was treated by nitroglycerin group on the basis of conventional therapy.The status of dyspnea and the overall clinical status after medication,hemodynamic parameters difference before medication and 24 h after medication,ventricular arrhythmia before medication and 72 h after medication were compared between the two groups.Results 0.5,6 and 24 h after medication,the status of dyspnea and the overall clinical status of rhBNP group were better than those of the nitroglycerin group,and the difference was statistically significant(P<0.05).Before medication and 24 h after medication,left ventricular ejection fraction,pulmonary arterial pressure,pulmonary capillary wedge pressure(PWCP),systolic blood pressure difference of nitroglycerin group were(+0.36±3.68)%,(+1.22±2.03)mm Hg(1 mm Hg=0.133 kPa),(-7.68±1.06)mm Hg and(+0.21±5.03)mm Hg respectively,and those of rhBNP group were(+4.07±1.25)%,(-2.87±1.60)mm Hg,(-4.21±1.03)mm Hg and(-3.53±1.44)mm Hg respectively.24 h after medication,the increase of left ventricular ejection fraction,the decrease of pulmonary artery pressure,PCWP and systolic blood pressure of rhBNP group were significantly better than those of nitroglycerin group,and the difference was statistically significant(P<0.05).72 h after medication,the frequency of decreased heart rate,premature ventricular beat,paired ventricular premature beat,paroxysmal ventricular tachycardia in the rhBNP group was significantly less than that in the nitroglycerin group,and the difference was statistically significant(P<0.05).Conclusion Recombinant human brain natriuretic peptide shows definite efficacy for patients with acute heart failure,and it can signi

关 键 词：重组人脑利钠肽 硝酸甘油 急性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]