重组人脑利钠肽治疗高龄心力衰竭患者的有效性和安全性  

The safety and effectiveness of recombinant human brain natriuretic peptide in heart failure treatmenpt for aged patients

作　　者：张含兵 郭传超 张冉 马晓 王萍[1] 朱婷婷 段鲁勤[1] ZHANG Hanbing;GUO Chuanchao;ZHANG Ran;MA Xiao;WANG Ping;ZHU Tingting;DUAN Luqin(Department of Geriatric Cardiology Taian City Central Hospital,Taian 271000,China)

机构地区：[1]泰安市中心医院老年心血管病科,山东泰安271000

出　　处：《山东第一医科大学（山东省医学科学院）学报》2023年第5期361-365,共5页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

摘　　要：目的 评价重组人脑利钠肽(recombinant human brain natriuretic peptide,rh-BNP)治疗高龄心力衰竭患者的有效性和安全性。方法 回顾性分析2021年2月至2022年2月泰安市中心医院老年心血管病科诊治的年龄在80岁及以上的心力衰竭患者93例,其中47例为观察组,在标准抗心衰治疗同时静脉应用rh-BNP以0.007 5~0.01μg/(kg·min)持续泵入,3 d后停药。余46例为对照组,仅应用标准抗心衰治疗。治疗前、治疗3 d后检测所有患者N末端B型利钠肽原(N-erminal prob-type natriuretic peptide,NT-proBNP)、C反应蛋白(C reactive protein,CRP)、血清肌酐、血钾、血钠值。统计治疗期间患者头痛、症状性低血压、新发心律失常等不良反应发生情况。结果 治疗3 d后观察组患者较治疗前NT-proBNP(4 784.89 vs. 2 825.30 pg/mL,P=0.022)、CRP(38.53 vs. 13.95 mg/L,P=0.036)显著下降,差异有统计学意义,肌酐上升(107.65 vs. 121.56μmol/L,P=0.387),差异无统计学意义,但结合实际考虑有临床意义。治疗3 d后对照组较治疗前NT-proBNP(4 163.91 vs. 4 481.91 pg/ml)、CRP(35.45 vs. 39.74 mg/L)、肌酐(101.23 vs. 99.61μmol/L)变化,差异均无统计学意义(P> 0.05)。两组患者治疗过程中均未出现电解质紊乱现象。治疗过程中两组各有1例患者死亡(观察组2.12%,对照组2.17%),观察组治疗总有效率为78.72%,显著有效率为44.68%,无效率为21.27%;对照组治疗总有效率为76.08%,显著有效率为28.26%,无效率为21.74%;两组比较差异均无统计学意义(P> 0.05)。治疗过程中出现症状性低血压3例,其中观察组1例(1.80%),对照组2例(4.40%),两组比较差异无统计学意义(P> 0.05)。未观察到与rh-BNP相关的头痛与新发心律失常。结论 较标准心衰治疗,静脉应用rh-BNP可明显降低老年心力衰竭患者NT-proBNP、CRP水平,且不增加电解质紊乱、症状性低血压、头痛、新发心律失常发生率。但在治疗终点时对心功能改善、临床症状缓解无明显优�Objective:To analyze the Safety and effectiveness of recombinant human brain natriuretic peptide in heart failure treatment for aged patients.Methods:This study reviewed 93 heart failure cases of patients aged over 80 years treated with standard anti heart failure medications from February 2021 to February 2022.The experimental group(47 patients)were treated with rh-BNP[0.0075-0.01µg/(kg∙min)]for 3 days,whilethe control group(46 patients)were treated only with standard medications.The NT-proBNP,CRP,serum creatinine,serum potassium and serum sodium were recorded and analyzed before treatment and 3 days after treatment.Meanwhile,the adverse reactions of the two groups,such as headache,low blood pressure,and new occurring arrhythmia were recorded and analyzed.Results:,The NT-proBNP value decreased from 4784.89 pg/mL to 2825.30 pg/mL,and CRP value decreased from 38.51 mg/L to 13.95 mg/L in the patients in experimental group at 3 days after treatment.These differences were statistically significant(P<0.05).Although the creatinine value increased from 107.65µmol/L to 121.56µmol/L without statistically significant difference(P>0.05),it was meaningful in clinical practice.On the contrast,the NT-proBNP value slightly increased from 4163.91 pg/mL to 4481.91 pg/mL,CRP value slightly increased from 35.45 mg/L to 39.74 mg/L,and creatinine value slightly decreased from 101.23µmol/L to 99.61µmol/L in the patients in control group.These differences in control group were not statistically significant(P>0.05).No electrolyte disturbance was found in both groups.One patient died in each group during the treatment.In experimental group,the total efficient rate was 78.72%,significant efficient rate was 44.68%,and non-efficient rate was 21.27%.In control group,the total efficient rate was 76.08%,significane efficient rate was 28.26%,and non-efficient rate was 21.74%.There were no statistically significant differences between the two groups(P>0.05).A total of 3 cases of hypotension occurred during the treatment,and 1 in experimen

关 键 词：重组人脑利钠肽 高龄 心力衰竭 疗效 安全性 

分 类 号：R541.6[医药卫生—心血管疾病]