医学PE1脂微球对肺心病并心力衰竭病人脑钠肽影响.docVIP

PGE1脂微球对肺心病并心力衰竭病人脑钠肽影响 作者：章政 王成军 刘志明 王新华 毛拥军 【摘要】 目的 观察前列腺素E1 脂微球(Lipo PGE1)对肺心病并心力衰竭病人脑钠肽（BNP）的影响。方法将120例肺源心脏病病人随机分为治疗组和对照组，各60例。两组治疗期间均停用其他扩血管药物，给予控制诱因、持续低流量吸氧、强心、利尿等常规抗心力衰竭治疗，积极抗感染、纠正电解质及酸碱失衡等，治疗组在一般治疗基础上给予Lipo PGE1 10 μg／d静脉推注，疗程14 d。比较两组治疗前后血BNP以及心脏指数(CI)。结果 两组病人治疗后BNP较治疗前均显著降低(t=2.02、7.91，P＜0.05、0.01),治疗组BNP较对照组显著降低（t=4.91,P＜0.05)。治疗后两组病人CI较治疗前均显著增加(t=2.00、4.65，P＜0.05、0.01)，且治疗组CI显著大于对照组(t=3.59，P＜0.05)。 结论 静脉推注Lipo PGE1治疗肺心病并心力衰竭疗效显著,在明显降低BNP的同时可提高CI。 【关键词】 前列地尔；肺心病；利钠肽，脑；心脏指数 　　［ABSTRACT］ Objective To observe the effect of Lipo PGE1 on plasma levels of brain natriuretic peptide (BNP) in patients with pneumocardial disease (PD) complicated heart failure. Methods This study comprised 120 patients with PD, who wereequally randomized to treatment group and control group. During the treatment, other vasodilating agents were discontinued in both groups. They were given control of inducement, inhalation of lowflow oxygen, administration of diuretics and antibiotics.Those in the treatment group, intravenous Lipo PGE1 10 μg/d was added for 14 days. BNP and cardiac index (CI) before and after treatment were compared. Results The plasma levels of BNP decreased significantly in both groups after the traetment (t=2.02,P＜0.05;t=7.91,Plt;0.01). Before treatment, the levels of BNP in the treatment group were significantly lower than that in control group (t=4.91,Plt;0.05). CI in both groups increased (t=2.00,Plt;0.05;t=4.65,Plt;0.01) after treatment and even higher in the treatment group (t=3.59,Plt;0.05). Conclusion Intravenous injection of Lipo PGE1 is effective for PD complicated heart failure, with significantly decreasing the plasma levels of brain natriuretic peptide and increasing the CI. 　　［KEY WORDS］ alprostadil; pulmonary heart disease; natriuretic peptide, brain; cardiac index 　　前列腺素E1 脂微球（Lipo PGE1）利用脂微球载体在人体内特异性分布特性，使药物更好地聚集于炎症病灶和病变血管处，发挥靶向作用。本文观察Lipo PGE1对肺心病并心力衰竭病人脑钠肽（BNP）水平、肺动脉压及心脏指数（CI）的影响，现将结果报告如下。 　　1 对象和方法 　　1.1 研究对象 　　慢性肺心病并心力衰竭病人120例，