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重组人脑利钠肽治疗急性失代偿性心力衰竭的临床观察
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| 篇名： | 重组人脑利钠肽治疗急性失代偿性心力衰竭的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨重组人脑利钠肽治疗急性失代偿性心力衰竭患者的效果、预后及安全性。方法：选择急性失代偿性心力衰竭住院患者90例，根据其是否使用重组人脑利钠肽将其分为观察组和对照组，各45例。对照组患者以20 μg/min的速度持续静脉滴注硝酸甘油注射液72 h进行常规抗心力衰竭治疗。观察组在对照组基础上，以1.5 μg/kg为初始负荷剂量给予冻干重组人脑利钠肽，静脉注射后，以0.007 5 μg/（kg·min）的速度持续静脉滴注72 h。观察比较两组患者治疗前后血流动力学参数、脑钠肽水平、液体出入量差及呼吸困难、肺部啰音、周身水肿情况，评价两组患者的心功能改善效果，并观察其用药后30 d再入院率、生存率，以及不良反应发生情况。结果：治疗后，观察组患者左心室射血分数显著高于对照组，中心静脉压和脑钠钛水平显著低于对照组，差异均有统计学意义（P＜0.05）。治疗后，观察组患者24 h液体出入量差为（1 171.60±444.80）ml，对照组为（822.30±268.40）ml，组间比较差异有统计学意义（P＜0.05）。治疗后，两组患者呼吸困难、肺部啰音、周身水肿评分均较治疗前显著降低，且观察组显著优于对照组，差异均有统计学意义（P＜0.05）。观察组和对照组患者总有效率分别为95.56％和82.22％，用药后30 d再入院率分别为17.78％和26.67％，用药后30 d生存率为88.89％和75.56％，组间比较差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：重组人脑利钠肽能明显改善急性失代偿性心力衰竭患者血流动力学参数和心功能，有效缓解患者呼吸困难、肺部啰音和周身水肿症状，预后较常规治疗好，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects， prognosis and safery of recombinant human brain natriuretic peptide on the treatment of patients with acute decompensated heart failure. METHODS： 90 inpatients with acute decompensated heart failure were divided into observation group and control group according to the use of recombinant human brain natriuretic peptide or not， with 45 cases in each group. Control group received rountine anti-heart failure therapy and intravenous dripping of Nitroglycerin injection at 20 μg/min continuously for 72 h. Observation group was additionally given Lyohilized recombinant human brain natriuretic peptide with initial loading amount of 1.5 μg/kg， iv， then intravenous dropping at 0.007 5 μg/（kg·min） continuously for 72 h， on the basis of control group. Hemodynamic parameters， brain natriuretic peptide level， the difference of liquid intake and output， dyspnea， lung rales， systemic edema， the improvement of cardiac function were observed and compared between 2 groups before and after treatment as well as re-hospitalization rate and surriral rate 30 d after medication， the occarrence of ADR. RESULTS： After treatment， left ventricular ejection fraction of observation group was significantly higher than that of control group， and central venous pressure and brain natriuretic peptide level were lower than those of control group， with statistically significance （P＜0.05）. The difference of liquid intake and output after treatment was （1 171.60±444.80）ml in observation group and （822.30±268.40）ml in control group， with statistical significance between 2 groups （P＜0.05）. After treatment， the scores of dyspnea， lung rales and systemic edema were decreased in 2 groups； the improvement of observation group was significantly better than that of control group， with statistical significance （P＜0.05）. Total effective rates of observation group and control group were 95.56％ and 82.22％； re-hospitalization rates 30 d after medication were 17.78％ and 26.67％； survival rates 30 d after medication were 88.89％ and 75.56％， with statistical significance between 2 groups （P＜0.05）. There was no statistical significanse in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and heart function of patients with acute decompensated heart failure， and effectively relieve dyspnea， lung rales and systemic edema. It is better than routine treatment in prognosis with good safety. |
| 期刊： | 2016年第27卷第35期 |
| 作者： | 王小燕，马富华 |
| AUTHORS： | WANG Xiaoyan，MA Fuhua |
| 关键字： | 重组人脑利钠肽；失代偿性心力衰竭；左室射血功能；预后 |
| KEYWORDS： | Recombinant human brain natriuretic peptide； Decompensated heart failure； Left ventricular ejection function； Prognosis |
| 阅读数： | 447 次 |
| 本月下载数： | 2 次 |
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