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目的观察国产重组人脑利钠肽(rhBNP)治疗急性冠脉综合征(ACS)致急性心衰的疗效及安全性。方法2005年12月—2007年12月在天津市天和医院心内科住院诊断为急性冠脉综合征致急性心衰患者36例,在常规使用利尿剂、抗凝、抗血小板聚集、调脂、及血管紧张素转换酶抑制剂、β受体阻滞剂等药物治疗基础上加用国产rhBNP,连用48h,测定治疗前和停止用药4h后的血浆中BNP水平,收缩压、舒张压、心率、左室射血分数LVEF(%)、左室舒末内径(LVED)、左房内径(LAED)等指标。比较rhBNP治疗前后上述指标的变化。结果rhBNP治疗后患者血浆中BNP水平降低(781.3±355.3)pg/ml(P<0.01),LVEF提高(6.11±4.2)%(P<0.01),心率下降(19.33±12.37)次/min(P<0.01),左房内径减少(5.56±3.10)mm(P<0.01),左室内径和收缩压变化无明显差异。结论急性冠脉综合征致急性心衰使用rhBNP静脉注射治疗是有效和安全的。
Objective To observe the efficacy and safety of domestic recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute coronary syndrome (ACS) induced acute heart failure. Methods From December 2005 to December 2007, 36 patients with acute heart failure caused by acute coronary syndrome were diagnosed in Department of Cardiology, Tianhe Hospital, Tianjin. In routine use of diuretics, anticoagulation, antiplatelet aggregation, lipid regulation, And angiotensin converting enzyme inhibitors, β-blockers and other drugs based on the addition of domestic rhBNP, once every 48h, determination of plasma BNP levels, systolic blood pressure, diastolic blood pressure, heart rate, Left ventricular ejection fraction LVEF (%), left ventricular end-diastolic diameter (LVED), left atrium diameter (LAED) and other indicators. Comparison of rhBNP before and after treatment of the above indicators of change. Results BNP level in plasma was decreased significantly (781.3 ± 355.3) pg / ml (P <0.01), LVEF increased (6.11 ± 4.2)%, and heart rate decreased <0.01), and the diameter of left atrium decreased (5.56 ± 3.10) mm (P <0.01). There was no significant difference in LV diameter and systolic pressure. Conclusion The acute coronary syndrome induced acute heart failure using rhBNP intravenous injection is effective and safe.