摘要
目的探讨重组人脑利钠肽(rhBNP)治疗顽固性心力衰竭(RHF)的疗效和安全性。方法将86例RHF患者采用单盲法随机分为常规治疗联合静脉滴注硝酸甘油(NTG)治疗组(NTG组,n=43)和常规治疗联合rhBNP治疗组(rhBNP组,n=43)。NTG组患者NTG初始以5μg/min的速率静脉泵入,然后根据患者的血压、心率,每3～5分钟增加5～10μg,至20μg/min,连用3d;rhBNP组rhBNP首次负荷剂量1.5～2.0μg/kg静脉推注,继而以速率0.007 5～0.010 0μg.kg-1.min-1,连续静脉泵入3d。停用NTG和rhBNP后,继续常规抗心力衰竭治疗,7d后比较两组患者治疗前、后的临床症状、心功能、尿量,以及血浆BNP、肌酐、钠、钾浓度的变化及不良反应的发生率。结果与NTG组比较,rhBNP组患者临床症状(血压、尿量、呼吸困难程度)、心功能及血浆BNP水平都得到明显改善(P<0.05);且rhBNP组患者不良反应发生率与NTG组比较,差异无统计学意义(P>0.05)。结论 rhBNP能明显改善RHF患者的临床症状、心功能及血浆BNP水平,其用于治疗RHF疗效显著,安全性高。
Objective To observe the effect of recombinant human brain natriuretic peptide（rhBNP） for the treatment of refrac tory heart failure（RHF）. Methods 86 inpatients with RHF were randomized into the conventional therapy plus nitroglycerin group （NTG group,n： 43） and the conventional therapy plus rbBNP group（rhBNP group, n： 43）. The NTG group was intravenously pumped with NTG in a dose of 5 μg/min by intravenous pumping at first,then increased in ramp of 5--10 /~g per 3--5 min to 20μg/min for continuous 3 d（the ramp depend on the blood pressure and the heart rate of patients）. The rhBNP group was intravenously pumped with rhBNP in a dose of 1.5--2.0 /~g/kg. min by intravenous injection at first,then increased to 0. 007 5 0. 010 0μg/kg min lasting for continuous 3 d. Both NTG and rhBNP were stopped and the regular anti heart failure therapy was adopted. The clinical symptoms including blood pressure, urine volume, dyspnea, heart function, the level of plasma BNP, creatinine, K＋ and Na＋ in both two groups were observed after 7 d treatment of routine anti-HF. Results Compared with the NTG group,the clinical symptoms, heart function, the level of plasma BNP in the rhBNP group were significantly improved（P〈0.05）. There was no difference in the incidence of adverse reactions in two groups（P〈0.05）. Conclusion rhBNP could significantly improve the clinical symptoms, heart function and the level of plasma BNP in the patients with RHF, which has significant effect and high safety for the treatment of RHF.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第27期2804-2806,2809,共4页
Chongqing medicine
关键词
利钠肽
脑
硝酸甘油
心力衰竭
natriuretic peptide, brain
nitroglycerin
heart failure
