临床研究冻干重组人脑利钠肽治疗慢性充血性心力衰竭疗效观察.docVIP

临床研究冻干重组人脑利钠肽治疗慢性充血性心力衰竭疗效观察 　　【摘要】 目的 观察冻干重组人脑利钠肽治疗慢性充血性心力衰竭的临床疗效。方法 80例慢性充血性心力衰竭患者随机分为新活素组40例和对照组40例。两组患者均给予标准的抗心力衰竭治疗，新活素组加用冻干重组人脑利钠肽，首次负荷剂量为1.5 μg/kg静脉注射，然后按0.0075 μg/(kg?min)剂量持续静脉泵入，连续用药72 h。观察患者治疗前及治疗后1周的临床症状、血浆中NT?proBNP的浓度及左室射血分数(LVEF)等情况。结果 新活素组的治疗总有效率显著优于对照组(P 　　【关键词】 　　冻干重组人脑利钠肽；慢性充血性心力衰竭；NT?proBNP；LVEF 　　?? 　　 　　Curative effect of recombinant human brain natriuretic peptide on treating chronic congestive heart failure 　　 　　TIAN Zhi?peng. 　　Department of Cardiovasology, FengtianHospital of Shenyang Medical College, Liaoning 110024, China 　　? 　　 　　【Abstract】 Objective To explore the clinical curative effect of recombinant human brain natri?uretic peptide in chronic congestive heart failure. Methods Eighty patients with chronic congestive heart failure were randomly divided into the Xinhuosu group(40 patients) and the control group (40 patients). The patients in both groups were given standard anti?heart failure therapy. The Xinhuosu group was added rhBNP. For the first time loading dose of 1.5 μg/kg intravenous injection, and then press0.0075 μg/(kg?min) dose continuous intravenous pump, continuous medication 72 h. Observed the clinical symptoms, the plasma NT?proBNP concentration and left ventricular ejection fraction (LVEF) in patients before and one week after treatment. Results The efficiency and the total effective rate of the Xinhuosu group was significantly better than that of control group(P［1］。本研究通过临床观察心衰相关指标的变化情况， 观察冻干重组人脑利钠肽治疗慢性充血性心力衰竭的疗效。? 　　1 资料与方法? 　　1.1 一般资料 　　选择2009年6月至2010年6月在沈阳医学院奉天医院循环科住院的患者80例， 均依据病史、症状体征、心电图、胸部X线及超声心动图检查而确诊为慢性充血性心力衰竭。随机分为两组。①新活素组40例：男23例，女17例；年龄33~91岁,平均(71.6±8.3)岁；住院时间10~22 d,平均(12.9±3.7) d。冠心病33例，扩张型心肌病5例，风心病2例。②对照组40例：男24例，女16例；年龄36~88岁,平均(69.9±7.8)岁；住院时间9~26 d,平均(14.1±4.7)d。冠心病32例，扩张型心肌病5例，风心病3例。两组病例均除外心源性休克、血容量不足、急性心梗后并有机械性并发症、肥厚型及限制型心肌病、缩窄性心包炎、肺源性心脏病、严重先天性心脏病、严重肝肾功能不全及恶性肿瘤者。? 　　1.2 方法 　　两组患者均给予标准的抗心衰治疗，包括去除诱发因素，改善血流动力学，减少神经体液因子过分激活，治疗原发病等。新活素组在此基础上加用冻干重组人脑利钠肽(新活素，成都诺迪康生物制药有限公司，批号：，首次负荷