西南国防医药
西南國防醫藥
서남국방의약
MEDICAL JOURNAL OF NATIONAL DEFENDING FORCES IN SOUTHWEST CHINA
2014年
8期
841-843
,共3页
重组人脑利钠肽%难治性心力衰竭%老年%疗效
重組人腦利鈉肽%難治性心力衰竭%老年%療效
중조인뇌리납태%난치성심력쇠갈%노년%료효
recombinant human brain natriuretic peptide(rhBNP)%refractory heart failure(RHF)%senile people%curative effect
目的：观察重组人脑利钠肽（rhBNP）治疗老年难治性心力衰竭（RHF）的临床疗效及安全性。方法将我院2010年1月~2014年1月收治的126例老年 RHF 患者随机分为观察组和对照组，每组63例。对照组给予常规抗心力衰竭治疗；观察组在对照组基础上，首先给予 rhBNP 1.5μg/ kg 静脉负荷量，而后以0.0075μg/（kg·min）的速度维持静脉滴注72 h。治疗3 d，观察两组临床疗效，并测量治疗前后心率、血压、血氧饱和度、左室舒张末内径及左室射血分数，记录不良反应的发生情况。结果治疗结束后，两组临床症状均有不同程度的改善，观察组总有效率为88.9%，明显高于对照组的68.3%（P ﹤0.05）；观察组心率、血氧饱和度、左室舒张末内径及左室射血分数较治疗前均显著改善，且明显优于治疗后对照组（ P ﹤0.05）；两组血压与治疗前相比无明显变化（P ﹥0.05）；观察组治疗期间1例（1.6%）出现低血压，给予减慢给药速度后不良反应消失，其余未见严重不良反应。两组不良反应发生率无明显差异（P ﹥0.05）。结论 rhBNP 治疗老年 RHF 临床疗效确切，能显著改善患者的临床症状及心功能指标，具有良好的安全性。
目的：觀察重組人腦利鈉肽（rhBNP）治療老年難治性心力衰竭（RHF）的臨床療效及安全性。方法將我院2010年1月~2014年1月收治的126例老年 RHF 患者隨機分為觀察組和對照組，每組63例。對照組給予常規抗心力衰竭治療；觀察組在對照組基礎上，首先給予 rhBNP 1.5μg/ kg 靜脈負荷量，而後以0.0075μg/（kg·min）的速度維持靜脈滴註72 h。治療3 d，觀察兩組臨床療效，併測量治療前後心率、血壓、血氧飽和度、左室舒張末內徑及左室射血分數，記錄不良反應的髮生情況。結果治療結束後，兩組臨床癥狀均有不同程度的改善，觀察組總有效率為88.9%，明顯高于對照組的68.3%（P ﹤0.05）；觀察組心率、血氧飽和度、左室舒張末內徑及左室射血分數較治療前均顯著改善，且明顯優于治療後對照組（ P ﹤0.05）；兩組血壓與治療前相比無明顯變化（P ﹥0.05）；觀察組治療期間1例（1.6%）齣現低血壓，給予減慢給藥速度後不良反應消失，其餘未見嚴重不良反應。兩組不良反應髮生率無明顯差異（P ﹥0.05）。結論 rhBNP 治療老年 RHF 臨床療效確切，能顯著改善患者的臨床癥狀及心功能指標，具有良好的安全性。
목적：관찰중조인뇌리납태（rhBNP）치료노년난치성심력쇠갈（RHF）적림상료효급안전성。방법장아원2010년1월~2014년1월수치적126례노년 RHF 환자수궤분위관찰조화대조조，매조63례。대조조급여상규항심력쇠갈치료；관찰조재대조조기출상，수선급여 rhBNP 1.5μg/ kg 정맥부하량，이후이0.0075μg/（kg·min）적속도유지정맥적주72 h。치료3 d，관찰량조림상료효，병측량치료전후심솔、혈압、혈양포화도、좌실서장말내경급좌실사혈분수，기록불량반응적발생정황。결과치료결속후，량조림상증상균유불동정도적개선，관찰조총유효솔위88.9%，명현고우대조조적68.3%（P ﹤0.05）；관찰조심솔、혈양포화도、좌실서장말내경급좌실사혈분수교치료전균현저개선，차명현우우치료후대조조（ P ﹤0.05）；량조혈압여치료전상비무명현변화（P ﹥0.05）；관찰조치료기간1례（1.6%）출현저혈압，급여감만급약속도후불량반응소실，기여미견엄중불량반응。량조불량반응발생솔무명현차이（P ﹥0.05）。결론 rhBNP 치료노년 RHF 림상료효학절，능현저개선환자적림상증상급심공능지표，구유량호적안전성。
Objective To observe the curative effect of recombinant human brain natriuretic peptide(rhBNP)on refractory heart failure(RHF)in senile patients and the safety. Methods 126 senile patients with RHF hospitalized in the period from Jan. ,2010 to Jan. ,2014 were randomly divided into 2 groups:observation group and control group,63 in each;patients in both groups were given routine anti heart failure therapy,while the patients in observation group were added with loading dose of rhBNP(1. 5 μg/ kg intravenously),and followed by intravenous infusion of rhBNP at a rate of 0. 0075 μg/(kg·min)for 72 hours;the course lasted for 3 days;the clinical curative effects in the 2 groups were observed,and the heart rate,blood pressure,blood oxygen saturation,LVEDd and LVEF of patients were measured before and after treatment;the occurrence of side effect was recorded. Results After treatment, improvement was found in both groups;the total effective rate was 88. 9% in observation group,much higher than that in control group (P ﹤0. 05);the improvement of heart rate,blood oxygen saturation,LVEDd and LVEF in observation group was superior to that in control group(P ﹤ 0. 05);no obvious changes in blood pressure were found in both groups(P ﹥ 0. 05);A case of hypotension occurred in observation group(1. 6% )and was dismissed after decreasing the speed of drug application,no serious side effect was found in others;there existed no obvious difference in the occurrence of side effect between the 2 groups(P ﹥ 0. 05). Conclusions rhBNP is of definite curative effect on RHF of the senile patients with good safety,and it can improve the clinical symptoms and heart function index.
