重組人腦利鈉肽治療老年急性失代償性心力衰竭患者的療效及安全性觀察

摘要： 目的探討重組人腦利鈉肽(rhBNP)治療老年急性失代償性心力衰竭患者的臨床療效及安全性。方法 82例老年急性失代償性心力衰竭患者,隨機分為治療組(rhBNP組)及硝普鈉對照組。并應(yīng)用超聲心動圖及Swan-Ganz導(dǎo)管檢測患者心功能、血流動力學參數(shù)變化,比較2組患者臨床狀況、心功能、血漿NTproBNP及血流動力學參數(shù)及不良事件的差異。結(jié)果 2組患者呼吸困難減輕,血氧飽和度提高,rhBNP組優(yōu)于對照組。治療后2組患者NT-proBNP均降低,rhBNP組降低顯著。患者左室射血分數(shù)、心指數(shù)均有提高,rhBNP組升高更明顯。2組患者血流動力學參數(shù)(PCWP、PAP)均降低,rhBNP組明顯優(yōu)于對照組,且在用藥30分鐘時2組即顯現(xiàn)出明顯差異;治療24小時時2組PCWP分別降低:12.29mmHg、8.8 mmHg,PAP降低:15.56 mmHg、11.42 mmHg,rhBNP組明顯優(yōu)于對照組;2組患者治療前后肝、腎功能無明顯差異;rhBNP組的不良事件主要是低血壓,但與對照組相比差異無顯著性。結(jié)論 rhBNP治療老年急性失代償性心力衰竭療效顯著,安全性較高,短期效果優(yōu)于常規(guī)硝普鈉治療。
Objective To observe the efficacy and safety of intravenous infusion recombinant human brain natriureticpeptide on elderly patients with ADHF.Methods A total of 82 patients who suffered from ADHF were randomized into rhBNP group and control group,The rhBNP group received rhBNP.The control group was used sodium nitroprusside for 48 hrs.all the patients were treated with traditional heart failure treatment.Observed improvement in symptoms,The changes in Blood pressure,renal function,left ventricular ejection fraction(LVEF)before and after treatment.Then,depending on the use of Swan-Ganz,Observed the change of capillary wedge pressure,and pulmonary arterial pressure.Results Dyspnea and oxygen saturation improvements were more significant in rhBNP group compared to control group.The NT-proBNP values were decrease in two groups,and the rhBNP group was better. Both LVEF and CI were improved after rhBNP,and the rhBNP group was better.PCWP and PAP were both after therapies therapies and there was more significant reduction in PCWP and PAP between 30 min in rhBNP group compared to control group.The blood pressure of both were decreased,MACE was also similar between the two groups.Conclusion Intravenous injection of rhBNP is efficient and safe for acute decompensated heart failure patients on elderly patients.it is also feasible and safe.