当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
30期
1-2
,共2页
难治性心力衰竭%重组人脑利钠肽%心功能%脑钠肽
難治性心力衰竭%重組人腦利鈉肽%心功能%腦鈉肽
난치성심력쇠갈%중조인뇌리납태%심공능%뇌납태
Refractory heart failure%Recombinant human brain natriuretic peptide%Cardiac function%Brain natriuretic peptide
目的：评价不同剂量冻干重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)治疗难治性心力衰竭(RHF)的临床疗效。方法四川省仁寿县人民医院将80例经常规抗心力衰竭药物治疗无明显改善的RHF患者随机分为小剂量组(n=36)和大剂量组(n=44)。首次负荷剂量1.5μg/kg静脉推注后，小剂量组以0.0075μg/(kg·min)继续静脉泵入维持治疗48 h，大剂量组以0.01μg/(kg·min)维持治疗48 h。观察2组患者治疗后心功能改善情况，以及24h尿量、左室射血分数(LVEF)和血浆脑钠肽(BNP)水平。结果2组心功能改善总有效率分别为80.6%、88.6%，差异无统计学意义。使用不同剂量rhBNP治疗后，2组患者24 h尿量较用药前明显增多，LVEF明显增加、血浆BNP水平明显下降，大剂量组改善更为显著，2组差异有统计学意义(P<0.05)。结论 rhBNP可以明显改善难治性心力衰竭患者近期心功能状态，缓解患者的症状，表现为尿量增多、LVEF升高，且不同剂量rhBNP对上述指标改善不同，但并不影响心功能的改善程度。
目的：評價不同劑量凍榦重組人腦利鈉肽(recombinant human brain natriuretic peptide,rhBNP)治療難治性心力衰竭(RHF)的臨床療效。方法四川省仁壽縣人民醫院將80例經常規抗心力衰竭藥物治療無明顯改善的RHF患者隨機分為小劑量組(n=36)和大劑量組(n=44)。首次負荷劑量1.5μg/kg靜脈推註後，小劑量組以0.0075μg/(kg·min)繼續靜脈泵入維持治療48 h，大劑量組以0.01μg/(kg·min)維持治療48 h。觀察2組患者治療後心功能改善情況，以及24h尿量、左室射血分數(LVEF)和血漿腦鈉肽(BNP)水平。結果2組心功能改善總有效率分彆為80.6%、88.6%，差異無統計學意義。使用不同劑量rhBNP治療後，2組患者24 h尿量較用藥前明顯增多，LVEF明顯增加、血漿BNP水平明顯下降，大劑量組改善更為顯著，2組差異有統計學意義(P<0.05)。結論 rhBNP可以明顯改善難治性心力衰竭患者近期心功能狀態，緩解患者的癥狀，錶現為尿量增多、LVEF升高，且不同劑量rhBNP對上述指標改善不同，但併不影響心功能的改善程度。
목적：평개불동제량동간중조인뇌리납태(recombinant human brain natriuretic peptide,rhBNP)치료난치성심력쇠갈(RHF)적림상료효。방법사천성인수현인민의원장80례경상규항심력쇠갈약물치료무명현개선적RHF환자수궤분위소제량조(n=36)화대제량조(n=44)。수차부하제량1.5μg/kg정맥추주후，소제량조이0.0075μg/(kg·min)계속정맥빙입유지치료48 h，대제량조이0.01μg/(kg·min)유지치료48 h。관찰2조환자치료후심공능개선정황，이급24h뇨량、좌실사혈분수(LVEF)화혈장뇌납태(BNP)수평。결과2조심공능개선총유효솔분별위80.6%、88.6%，차이무통계학의의。사용불동제량rhBNP치료후，2조환자24 h뇨량교용약전명현증다，LVEF명현증가、혈장BNP수평명현하강，대제량조개선경위현저，2조차이유통계학의의(P<0.05)。결론 rhBNP가이명현개선난치성심력쇠갈환자근기심공능상태，완해환자적증상，표현위뇨량증다、LVEF승고，차불동제량rhBNP대상술지표개선불동，단병불영향심공능적개선정도。
Objective To explore the efficacy of different doses of recombinant human brain natriuretic peptide on patients with refractory heart failure.Methods Eighty patients with refractory heart failure were randomly divided into low-dose group (n=36) and high-dose group (n=44). Besides traditional heart failure treatment, low-dose group was given continuous intravenous pump of 0.075μg/(kg?min) for 48h, while high-dose group was 0.01μg/(kg?min) for 48h after the first loading dose of 1.5μg/kg intravenous injection. Cardiac function improvement, 24h urine volume, left ventricular ejection fraction (LVEF), plasma BNP concentration before and after treatment were observed and compared between the two groups. Results The 24h urine volume, LVEF, plasma BNP in both groups improved significantly after treatment and the indexes of high-dose group changed more significantly than those of low-dose group (P<0.05). However, there was no significant difference in total effective rate of cardiac function improvement in both groups.Conclusion Different dose of rhBNP could significantly improve urination, LVEF and BNP of RHF sufferers, and high dose has stronger effect. However, different dose have no significant effect on cardiac function improvement.
