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目的观察静脉用重组人脑钠尿肽(rhBNP)对失代偿性心力衰竭患者的临床疗效。方法我院50例急性失代偿性心力衰竭住院患者随机分为硝普钠组和rhBNP组,分别记录两组患者给药前及给药后0.5h、6h及24h的呼吸困难程度以及整体临床情况,以及用药24h后液体的出入量和血流动力学参数。其中硝普钠组使用硝普钠(起始10μg/min,根据血压每10min增加5μg/min,维持在50~100μg/min),rhBNP组使用rhBNP[首先以1.5μg/kg弹丸式静脉冲击,随后以0.0075μg/(kg·min)连续静脉滴注24h]。结果静脉给药0.5h后rhBNP与硝普钠改善呼吸困难和整体临床状况的程度未见明显差异,6h及24h后rhBNP组患者的呼吸困难好转程度和整体临床状况好转程度显著优于硝普钠组(P<0.05);用药24h后rhBNP组的尿量(2014±243)ml明显多于硝普钠组(1341±240)ml(P<0.05);用药24h时rhBNP与硝普钠同样能明显增加患者的左室射血分数,以及明显降低肺动脉压和收缩压,但无统计学差异。结论rhBNP能明显改善急性失代偿性心力衰竭患者呼吸困难及整体临床状况。
Objective To observe the clinical effect of intravenous recombinant human brain natriuretic peptide (rhBNP) in patients with decompensated heart failure. Methods Fifty hospitalized patients with acute decompensated heart failure in our hospital were randomly divided into sodium nitroprusside group and rhBNP group. The degree of dyspnea was recorded before and 0.5h, 6h and 24h after treatment in the two groups, Situation, and after administration of liquid after 24 hours of access and hemodynamic parameters. Sodium nitroprusside (initial 10 μg / min, 5 μg / min increase every 10 min according to blood pressure, maintained at 50-100 μg / min) was used in the sodium nitroprusside group, and rhBNP was administered to the rhBNP group [first with 1.5 μg / kg bolus- Followed by continuous intravenous infusion of 0.0075μg / (kg · min) 24h]. Results After 0.5h intravenous administration of rhBNP and sodium nitroprusside to improve breathing difficulties and the overall clinical status of the degree of no significant difference, 6h and 24h rhBNP patients improved degree of dyspnea and overall clinical improvement was significantly better than sodium nitroprusside (P <0.05). The urine volume (2014 ± 243) ml in rhBNP group was significantly higher than that in sodium nitroprusside group (1341 ± 240) ml after 24h treatment (P <0.05) Significant increase in patients with left ventricular ejection fraction, and significantly reduce pulmonary artery pressure and systolic blood pressure, but no significant difference. Conclusion rhBNP can significantly improve dyspnea and overall clinical status in patients with acute decompensated heart failure.