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目的研究重组人B-型利钠肽对慢性心力衰竭急性失代偿患者的中远期疗效。方法试验对入选的107例慢性心力衰竭急性发作患者的临床资料采用随机、开放、平行对照方法进行采集和统计分析。入选患者随机分配为rhBNP组(n=40)和对照组,rhBNP组是在心衰常规治疗的基础上,加用新活素。患者出院后进行随访6个月,根据随访结果,判定患者出院后无急性失代偿性心衰发作的NT-proBNP下降幅度界定值;行不同治疗组的出院后无急性失代偿性心衰发作的生存分析。结果 NT-proBNP下降幅度≥35%患者的无急性失代偿性心衰发作的累积生存率明显高于NT-proBNP下降幅度<35%患者,P=0.001。rhBNP组患者无急性失代偿性心衰发作的均数明显超过标准治疗组患者(P≤0.05)。结论 rhBNP组患者出院后无急性失代偿性心衰发作的累积生存率明显高于标准治疗组患者,且NT-proBNP下降幅度≥35%者,其累积生存率最佳。
Objective To study the long-term efficacy of recombinant human B-type natriuretic peptide in patients with acute decompensation of chronic heart failure. Methods The clinical data of 107 patients with acute exacerbation of chronic heart failure were collected and analyzed by randomized, open and parallel control methods. The patients were randomly assigned to rhBNP group (n = 40) and control group. RhBNP group was treated with neomycin on the basis of conventional treatment of heart failure. Patients were followed up for 6 months after discharge. According to the follow-up results, NT-proBNP declines of patients without acute decompensated heart failure after discharge were determined. There was no acute decompensated heart failure after discharge in different treatment groups Survival analysis of seizures. Results The cumulative survival rate of patients with NT-proBNP decline> 35% was significantly higher than those with NT-proBNP decrease <35% (P = 0.001). The mean number of patients without acute decompensated heart failure in the rhBNP group was significantly greater than those in the standard treatment group (P <0.05). Conclusions The cumulative survival rate of rhBNP patients after discharge from the hospital without acute decompensated heart failure was significantly higher than that of the standard treatment group, and NT-proBNP decreased more than 35%. The cumulative survival rate was the best.