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目的:对比研究不同给药方式对重组人脑利钠肽(rhBNP)治疗慢性心力衰竭急性失代偿性重症(ADHF)患者的临床疗效。方法:入选ADHF患者62例随机分为2组,A组为rhBNP连续给药治疗组,B组为rhBNP间歇给药治疗组。观察2组治疗前后的临床疗效、心率、平均动脉压、尿量、心功能指标及血浆BNP水平变化。结果:与治疗前比较,治疗后各组心率、平均动脉压、尿量、左心室射血分数、血浆BNP水平、每搏输出量、心脏指数和心肌纵向应变率均得到改善(P<0.05或P<0.01)。治疗后,rhBNP连续给药治疗组的疗效稍强于rhBNP间歇给药治疗组。A组治疗总有效率与B组相比,无显著性差异(84.4%vs 73.3%)(P>0.05),但B组在血流动力学等参数(24 h尿量、心率、平均动脉压、BNP、LVEF、SV、CI)改善方面不亚于A组。结论:rhBNP治疗慢性心力衰竭急性失代偿重症患者疗效显著,可明显改善患者的心衰症状。rhBNP间歇给药的治疗方案也值得临床推广。
Objective: To compare the clinical effects of rhBNP in patients with acute decompensated chronic heart failure (ADHF) treated by different administration methods. Methods: Sixty-two ADHF patients were randomly divided into two groups. Group A was treated with rhBNP continuous administration and group B was rhBNP intermittent treatment. The clinical effects, heart rate, mean arterial pressure, urine output, cardiac function and plasma BNP levels in two groups before and after treatment were observed. Results: After treatment, heart rate, mean arterial pressure, urine output, left ventricular ejection fraction, plasma BNP level, stroke volume, cardiac index and myocardial longitudinal strain rate were all improved after treatment (P <0.05 or P <0.01). After treatment, rhBNP continuous treatment group was slightly better than rhBNP intermittent treatment group. The total effective rate in group A was not significantly different from that in group B (84.4% vs 73.3%) (P> 0.05), but there was no significant difference in group B between hemodynamics parameters (24 h urine output, heart rate, mean arterial pressure , BNP, LVEF, SV, CI) improved as much as Group A. Conclusion: rhBNP treatment of acute decompensated chronic heart failure patients with significant effect, can significantly improve the patient’s heart failure symptoms. Intermittent rhBNP treatment programs are also worthy of clinical promotion.