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目的观察重组人脑利钠肽(rhBNP)治疗老年慢性心衰急性加重期的临床疗效,对心功能、血清B型脑利钠肽(BNP)和去甲肾上腺素(NE)水平的影响。方法89例年龄≥65岁的慢性心衰急性加重期患者随机分为rhBNP治疗组(n=47)和硝普钠治疗组(n=42),观察两组患者治疗前后的临床疗效、心功能及血清BNP和NE水平的变化。结果rhBNP组治疗后24h临床显效率(51.06%)及总有效率(95.74%)均高于硝普钠组(分别为42.86%及83.33%,P<0.05);rhBNP组治疗后2w射血分数(EF)值升高(46.2±9.5)%vs(38.1±6.0)%,P<0.05;rhBNP组治疗后2w血清BNP水平较硝普钠组下降(P<0.05);rhBNP组治疗后24h血清BNP及NE水平均较基线值明显下降(P<0.01),且治疗后2w较24h有进一步降低(P<0.01);硝普钠组治疗后24h血清BNP及NE亦较基线值明显下降(P<0.01),治疗后2w血清BNP较24h有进一步降低(P<0.01),但血清NE与治疗后24h相比较差异不显著(P>0.05)。结论rhBNP能安全、有效地用于老年慢性心衰急性加重期的治疗。
Objective To observe the clinical effects of recombinant human brain natriuretic peptide (rhBNP) in the treatment of elderly patients with acute exacerbation of chronic heart failure (CHF) on cardiac function, serum BNP and norepinephrine levels. Methods A total of 89 patients aged ≥ 65 years old with acute exacerbation of chronic heart failure were randomly divided into rhBNP treatment group (n = 47) and sodium nitroprusside treatment group (n = 42). The clinical efficacy, cardiac function And serum BNP and NE levels. Results The clinical effective rate (51.06%) and total effective rate (95.74%) in rhBNP group were significantly higher than those in sodium nitroprusside group (42.86% vs 83.33%, P <0.05, respectively) (46.2 ± 9.5)% vs (38.1 ± 6.0)% respectively, P <0.05; serum BNP level in rhBNP group was lower than that in sodium nitroprusside group (P <0.05) BNP and NE levels were significantly lower than those at baseline (P <0.01), and further decreased after 2 weeks (P <0.01). Serum BNP and NE were also significantly decreased after treatment with sodium nitroprusside (P <0.01) (P <0.01). The serum BNP level at 2 weeks after treatment was lower than that at 24h (P <0.01). However, the serum level of NE was not significantly different from that at 24h after treatment (P> 0.05). Conclusion rhBNP can be safely and effectively used in the treatment of elderly patients with acute exacerbation of chronic heart failure.