重组人脑利钠肽对脓毒症诱导心功能障碍的影响
发布时间：2018-09-14 11:38
【摘要】：目的观察给予脓毒症患者重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)治疗后血清氮末端-前脑钠肽(N-terminal pro-B-type natriuretic peptide,NtproBNP)、肌钙蛋白(cTnI)、左室射血分数(LVEF)随时间的变化,探讨rhBNP对脓毒症诱导心功能障碍的干预效应。方法收集2013年2月至2015年5月期间我院重症医学科收治的脓毒症患者资料40例,随机均分为对照组和rhBNP组,两组患者除目标导向治疗(EGDT)外,rhBNP组静脉推注rhBNP 1.5μg/kg,后以0.075μg·kg-1·min-1持续泵入48h;对照组予以等容量生理盐水。在治疗过程中,可使用血管活性药物维持BP。两组患者分别于治疗前、治疗后第1、3、7天时采血行即时检验(point of care,POCT),检测血浆Nt-proBNP、肌钙蛋白I(cTnI);并同时于床旁行经胸心脏超声测定LVEF。结果治疗后第1、3天rhBNP组Nt-proBNP水平和cTnI明显低于对照组(P0.05),治疗后第3天两组Nt-proBNP水平和cTnI明显高于第1天和第7天(P0.01)。治疗后第3、7天rhBNP组LVEF明显高于对照组(P0.05或P0.01);治疗后第3天两组LVEF明显低于治疗前和第7天(P0.05或P0.01)。结论 rhBNP能降低脓毒症患者Nt-proBNP及cTnI,提高LVEF,显著改善脓毒症诱导的心功能障碍。
[Abstract]:Objective to observe the changes of serum nitrogen-forebrain natriuretic peptide (N-terminal pro-B-type natriuretic peptide,NtproBNP) and left ventricular ejection fraction (LVEF) of troponin (cTnI), after treatment with recombinant human brain natriuretic peptide (recombinant human brain natriuretic peptide,rhBNP) in septic patients. To investigate the effect of rhBNP on septic induced cardiac dysfunction. Methods from February 2013 to May 2015, 40 patients with sepsis were randomly divided into control group and rhBNP group. The patients in both groups were injected with rhBNP 1.5 渭 g / kg by intravenous injection, then continuously pumped with 0.075 渭 g kg-1 min-1 for 48 h, and those in the control group were given normal saline of equal volume. During treatment, vasoactive drugs can be used to maintain BP. Blood samples were collected before treatment and 3 days after treatment for immediate (point of care,POCT), plasma Nt-proBNP, troponin I (cTnI); was detected and transthoracic echocardiography was performed to determine LVEF. at the same time. Results the levels of Nt-proBNP and cTnI in the rhBNP group were significantly lower than those in the control group on day 1 and day 3 after treatment (P0.05), and the levels of Nt-proBNP and cTnI in the two groups on the 3rd day after treatment were significantly higher than those on the 1st and 7th day (P0.01). The LVEF of the rhBNP group was significantly higher than that of the control group on the 3rd day after treatment (P0.05 or P0.01), and the LVEF of the two groups on the 3rd day after treatment was significantly lower than that before treatment and on the 7th day (P0.05 or P0.01). Conclusion rhBNP can decrease Nt-proBNP and increase LVEF, in septic patients.
【作者单位】： 四川省人民医院重症医学科;
【分类号】：R459.7
[Abstract]:Objective to observe the changes of serum nitrogen-forebrain natriuretic peptide (N-terminal pro-B-type natriuretic peptide,NtproBNP) and left ventricular ejection fraction (LVEF) of troponin (cTnI), after treatment with recombinant human brain natriuretic peptide (recombinant human brain natriuretic peptide,rhBNP) in septic patients. To investigate the effect of rhBNP on septic induced cardiac dysfunction. Methods from February 2013 to May 2015, 40 patients with sepsis were randomly divided into control group and rhBNP group. The patients in both groups were injected with rhBNP 1.5 渭 g / kg by intravenous injection, then continuously pumped with 0.075 渭 g kg-1 min-1 for 48 h, and those in the control group were given normal saline of equal volume. During treatment, vasoactive drugs can be used to maintain BP. Blood samples were collected before treatment and 3 days after treatment for immediate (point of care,POCT), plasma Nt-proBNP, troponin I (cTnI); was detected and transthoracic echocardiography was performed to determine LVEF. at the same time. Results the levels of Nt-proBNP and cTnI in the rhBNP group were significantly lower than those in the control group on day 1 and day 3 after treatment (P0.05), and the levels of Nt-proBNP and cTnI in the two groups on the 3rd day after treatment were significantly higher than those on the 1st and 7th day (P0.01). The LVEF of the rhBNP group was significantly higher than that of the control group on the 3rd day after treatment (P0.05 or P0.01), and the LVEF of the two groups on the 3rd day after treatment was significantly lower than that before treatment and on the 7th day (P0.05 or P0.01). Conclusion rhBNP can decrease Nt-proBNP and increase LVEF, in septic patients.
【作者单位】： 四川省人民医院重症医学科;
【分类号】：R459.7
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