重组人脑利钠肽治疗急性失代偿性心力衰竭的临床观察

发布时间：2018-07-08 07:44

本文选题：重组人脑利钠肽 + 失代偿性心力衰竭　；参考：《中国药房》2016年35期

【摘要】：目的:探讨重组人脑利钠肽治疗急性失代偿性心力衰竭患者的效果、预后及安全性。方法:选择急性失代偿性心力衰竭住院患者90例,根据其是否使用重组人脑利钠肽将其分为观察组和对照组,各45例。对照组患者以20μg/min的速度持续静脉滴注硝酸甘油注射液72 h进行常规抗心力衰竭治疗。观察组在对照组基础上,以1.5μg/kg为初始负荷剂量给予冻干重组人脑利钠肽,静脉注射后,以0.007 5μg/(kg·min)的速度持续静脉滴注72 h。观察比较两组患者治疗前后血流动力学参数、脑钠肽水平、液体出入量差及呼吸困难、肺部Up音、周身水肿情况,评价两组患者的心功能改善效果,并观察其用药后30 d再入院率、生存率,以及不良反应发生情况。结果:治疗后,观察组患者左心室射血分数显著高于对照组,中心静脉压和脑钠钛水平显著低于对照组,差异均有统计学意义(P0.05)。治疗后,观察组患者24 h液体出入量差为(1 171.60±444.80)ml,对照组为(822.30±268.40)ml,组间比较差异有统计学意义(P0.05)。治疗后,两组患者呼吸困难、肺部Up音、周身水肿评分均较治疗前显著降低,且观察组显著优于对照组,差异均有统计学意义(P0.05)。观察组和对照组患者总有效率分别为95.56%和82.22%,用药后30 d再入院率分别为17.78%和26.67%,用药后30 d生存率为88.89%和75.56%,组间比较差异均有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:重组人脑利钠肽能明显改善急性失代偿性心力衰竭患者血流动力学参数和心功能,有效缓解患者呼吸困难、肺部Up音和周身水肿症状,预后较常规治疗好,且安全性较好。
[Abstract]:Objective: to investigate the efficacy, prognosis and safety of recombinant human brain natriuretic peptide in the treatment of patients with acute decompensated heart failure. Methods: 90 inpatients with acute decompensated heart failure were divided into observation group and control group according to whether they were treated with recombinant human brain natriuretic peptide (RBP). Patients in the control group were treated with conventional anti-heart failure at 20 渭 g/min continuous intravenous drip of nitroglycerin injection for 72 h. The experimental group was given lyophilized recombinant human brain natriuretic peptide at the initial loading dose of 1.5 渭 g/kg on the basis of the control group. After intravenous injection, 0.007 渭 g / (kg min) was continuously infused intravenously for 72 h. The hemodynamic parameters, brain natriuretic peptide (BNP) level, poor fluid flow and breathing difficulty, pulmonary up sound and peripheral edema were observed and compared between the two groups before and after treatment, and the improvement effect of cardiac function in the two groups was evaluated. The readmission rate, survival rate and adverse reaction were observed 30 days after treatment. Results: after treatment, the left ventricular ejection fraction (LVEF) in the observation group was significantly higher than that in the control group, and the central venous pressure and brain natrium and titanium levels were significantly lower in the observation group than in the control group (P0.05). After treatment, the difference of liquid volume in the observation group was (1 171.60 卤444.80) ml after 24 h, and that in the control group was (822.30 卤268.40) ml. The difference between the two groups was statistically significant (P0.05). After treatment, the two groups of patients with dyspnea, lung up, peripheral edema scores were significantly lower than before treatment, and the observation group was significantly better than the control group, the difference was statistically significant (P0.05). The total effective rates of observation group and control group were 95.56% and 82.22% respectively. The readmission rates were 17.78% and 26.67% respectively at 30 days after treatment. The 30-day survival rate was 88.89% and 75.56% respectively in the observation group and the control group. There was significant difference between the two groups (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and cardiac function in patients with acute decompensated heart failure, alleviate dyspnea, pulmonary uptone and peripheral edema symptoms, and have a better prognosis than conventional treatment. And the safety is good.
【作者单位】：河西学院第二附属医院内科;张掖市甘州区人民医院功能科;
【分类号】：R541.6

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