不同剂量重组人脑钠肽辅助治疗肺源性心脏病合并右心衰竭患者的预后观察  

Prognosis of Patients with Pulmonary Heart Disease Complicated with Right Heart Failure Treated with Different Doses of Recombinant Human Brain Natriuretic Peptide

作　　者：朱冬竹 雷玉琼 焦琳[1] ZHU Dongzhu;LEI Yuqiong;JIAO Lin(Department of Cardiology,Wuhan University Zhongnan Hospital,Wuhan 430061,China)

机构地区：[1]武汉大学中南医院心内科,湖北武汉430061

出　　处：《岭南心血管病杂志》2023年第5期515-519,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的研究不同剂量重组人脑钠肽(recombinant human brain natriuretic peptide,rhBNP)辅助治疗肺源性心脏病合并右心衰竭患者的临床疗效。方法纳入2020年4月至2020年10月武汉大学中南医院收治的116例肺源性心脏病合并右心衰竭患者为研究对象,按照随机数表法分为两组,各58例。两组均在常规治疗基础上予以rhBNP治疗,首次负荷剂量为1.5μg/kg,其中A组于负荷剂量后继续用rhBNP 0.01μg·kg^(-1)·min^(-1)静脉泵入,持续72 h;B组则于负荷剂量后继续用rhBNP 0.0075μg·kg^(-1)·min^(-1)静脉泵入,持续72 h。比较两组患者的治疗疗效,分析两组患者治疗前后心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)及N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)],比较两组患者治疗前后动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))、肺动脉收缩压(systolic pressure of pulmonary artery,PASP)及用力肺活量(forced vital capacity,FVC)水平,观察两组患者不良反应发生情况。结果两组患者治疗后临床治疗效率分别为87.93%(51/58)与72.41%(42/58),两组比较差异有统计学意义(P<0.05)。A组患者治疗后LVEF(36.28%±5.42%vs.47.76%±6.20%,P<0.05),PaO_(2)[(49.50±3.40)mmHg vs.(75.29±4.93)mmHg,P<0.05](1 mmHg=0.133 kPa)、FVC[(1.96±0.35)L vs.(2.68±0.49)L,P<0.05]均明显高于B组,NT-proBNP[(419.52±55.54)pg/mL vs.(271.56±40.10)pg/mL,P<0.05]、PaCO_(2)[(53.40±3.12)mmHg vs.(43.82±2.20)mmHg,P<0.05]均明显低于B组,差异有统计学意义。两组患者用药后不良反应发生率比较,差异无统计学意义[10.34%(5/58)vs.6.90%(4/58),P>0.05]。结论使用rhBNP 0.01μg·kg^(-1)·min^(-1)剂量维持治疗肺源性心脏病合并右心衰竭患者的疗效Objectives To study the clinical efficacy of different doses of recombinant human brain natriuretic peptide(rhBNP)in the adjuvant treatment of patitents with pulmonary heart disease complicated with right heart failure.Methods Totally 116 patients with pulmonary heart disease complicated with right heart failure treated in Wuhan University Zhongnan Hospital from April 2020 to October 2020 were included as the research objects.They were divided into two groups according to the random number table method,with 58 cases in each group.Both groups were treated with rhBNP on the basis of conventional treatment,and the first loading dose was 1.5μg/kg in which.A group received rhBNP 0.01μg·kg^(-1)·min^(-1)after loading dose,which was pumped intravenously for 72 h.B group received rhBNP 0.0075μg·kg^(-1)·min^(-1)after loading dose,which was pumped intravenously for 72 h.The therapeutic effects of the two groups were compared,and the cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and N-terminal pro-brain natriuretic peptide(NT-proBNP)]were analyzed before and after treatment.The levels of arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),pulmonary systolic pressure(PASP)and forced vital capacity(FVC)were compared between the two groups before and after treatment.Results The clinical treatment efficiency of the two groups after treatment was 87.93%(51/58)and 72.41%(42/58)respectively,with a statistically significant difference(P<0.05).After treatment,LVEF(36.28%±5.42%vs.47.76%±6.20%,P<0.05),PaO_(2)[(49.50±3.40)mmHg vs.(75.29±4.93)mmHg,P<0.05](1 mmHg=0.133 kPa),FVC[(1.96±0.35)L vs.(2.68±0.49)L,P<0.05]in A group were significantly higher than those in B group,NT-proBNP[(419.52±55.54)pg/mL vs.(271.56±40.10)pg/mL,P<0.05],PaCO_(2)[(53.40±3.12)mmHg vs.(43.82±2.20)mmHg,P<0.05]in A group were significantly lower than those in B group,and the differences were statist

关 键 词：肺源性心脏病 右心衰竭 重组人脑利钠肽 剂量 心功能 不良反应 

分 类 号：R541.6[医药卫生—心血管疾病]