CAJ | 학술논문

目的：观察使用重组人脑利钠肽（新活素）在瓣膜置换术后肺动脉血流动力学的变化。方法：对50例行瓣膜置换患者分为新活素组（25例）与对照组（25例），分别泵入新活素和生理盐水，连续使用72 h，观察用药后15 min、30 min、1 h、2 h、4 h、24 h的桡动脉收缩压（ABG）、中心静脉压（CVP）、肺动脉平均压（mPAP）、肺动脉楔压（PCWP）及心输出量（CO）、计算心脏指数（CI）和肺血管阻力（PVR）。结果：新活素组在用药30 min后，肺动脉平均压与对照组比较，变化值具有显著差异（P<0.05）、4 h后肺动脉楔压（PCWP）的变化值，新活素组与对照组比较明显下降（P<0.05）、心脏指数明显提高（P<0.01），新活素组总有效率优于对照组。结论：新活素能显著改善瓣膜置换术后患者的肺动脉血流动力学，且不增加药物不良反应。
목적：관찰사용중조인뇌리납태（신활소）재판막치환술후폐동맥혈류동역학적변화。방법：대50례행판막치환환자분위신활소조（25례）여대조조（25례），분별빙입신활소화생리염수，련속사용72 h，관찰용약후15 min、30 min、1 h、2 h、4 h、24 h적뇨동맥수축압（ABG）、중심정맥압（CVP）、폐동맥평균압（mPAP）、폐동맥설압（PCWP）급심수출량（CO）、계산심장지수（CI）화폐혈관조력（PVR）。결과：신활소조재용약30 min후，폐동맥평균압여대조조비교，변화치구유현저차이（P<0.05）、4 h후폐동맥설압（PCWP）적변화치，신활소조여대조조비교명현하강（P<0.05）、심장지수명현제고（P<0.01），신활소조총유효솔우우대조조。결론：신활소능현저개선판막치환술후환자적폐동맥혈류동역학，차불증가약물불량반응。
Objective: To observe the use of nesiritide (Lyophilized Recombinant Human Brain Natri-uretic Peptide) on the changes of pulmonary artery hemodynamics in patients after valve replacement. Methods: The 50 cases of valve replacement were divided into treatment group (25 cases) or control group (25 cases), the patients were respectively treated with nesiritide or physiological saline for 72 hours, and observed at 15 minutes, 30 minutes, 1 hours, 2 hours, 4 hours and 24 hours for radial artery systolic blood pressure (ABG), central venous pressure (CVP), mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PCWP) and cardiac output (CO). The cardiac index (CI) and pulmonary vascular re-sistance (PVR) were calculated. Results: Compared with the control group, the treatment group showed sig-nificantly different mPAP (P<0.05) after 30 minutes, obviously decreased PAWP (P<0.05) and increased CI (P<0.01) after 4 hours. Conclusion: Nesiritide can significantly improve the hemodynamics in patients with valve replacement, with no increase of adverse drug reaction.