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目的观察和比较重组人脑利钠肽(rh BNP)与硝普钠治疗难治性心力衰竭的临床效果。方法将92例顽固性心力衰竭住院患者随机分为对照组和研究组,每组46例,两组均给予常规治疗,包括吸氧、卧床休息、低脂低盐饮食和洋地黄类药物等抗心衰治疗。对照组在常规治疗基础上给予硝普钠,研究组则应用冻干rh BNP治疗,连续治疗72 h后观察其疗效。结果研究组治疗有效率高于对照组(91.3%vs 73.9%),差异有统计学意义(χ~2=5.91,P<0.05)。治疗前两组左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、每搏输出量(SV)、心输出量(CO)等心功能指标差异无统计学意义(P>0.05),治疗后两组心功能均有改善,与同组治疗前比较,差异均有统计学意义(P<0.05);而研究组改善程度高于对照组(P<0.05)。治疗后两组K~+、Na~+、转氨酶(ALT)、血清肌酐(Cr)无明显变化,而超敏C反应蛋白(hs-CRP)和血尿素氮(BUN)明显下降(P<0.05),研究组下降程度高于对照组(P<0.05)。结论 rh BNP对顽固性心力衰竭患者心功能具有明显改善作用,且能有效改善肾功能,其疗效优于硝普钠,有一定的临床应用价值。
Objective To observe and compare the clinical effects of recombinant human brain natriuretic peptide (rh BNP) and sodium nitroprusside in the treatment of refractory heart failure. Methods Ninety-two hospitalized patients with refractory heart failure were randomly divided into control group and study group, with 46 patients in each group. Both groups were given routine treatment including oxygen inhalation, bed rest, low-fat and low-salt diet and digitalis drugs Failure treatment. The control group was given sodium nitroprusside on the basis of routine treatment. The study group was treated with lyophilized rhBNP, and the curative effect was observed 72 hours after continuous treatment. Results The effective rate of treatment in study group was significantly higher than that in control group (91.3% vs 73.9%, χ ~ 2 = 5.91, P <0.05). Before treatment, there were no significant differences in cardiac function indexes such as left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), stroke volume (SV) and cardiac output (CO) (P <0.05). The improvement of the study group was higher than that of the control group (P <0.05). After treatment, the levels of K ~ +, Na ~ +, ALT and Cr in the two groups had no significant changes, while the levels of hs-CRP and BUN decreased significantly (P <0.05 ), The study group decreased more than the control group (P <0.05). Conclusions rh BNP can significantly improve cardiac function in patients with refractory heart failure, and can effectively improve renal function, its efficacy is superior to sodium nitroprusside, and has certain clinical value.