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重组人脑钠肽(rhBNP),即Nesiritide,具有扩张动脉和静脉、利尿排钠、降低血浆醛固酮水平等药理作用。2001年美国FDA批准Nesiritide用于治疗急性失代偿性心力衰竭(HF)。现已完成的VMAC、PRECEDENT等前瞻性临床试验初步揭示其治疗HF的有效性。然而,荟萃分析显示,rhBNP有可能导致肾功能恶化和增加死亡率。rhBNP价格昂贵,与价廉的硝酸甘油比较,在改善患者整体临床状况方面没有差异。对rhBNP治疗HF的进一步评价仍有待于多中心、前瞻性随机对照临床试验的揭晓。
Recombinant human brain natriuretic peptide (rhBNP), namely Nesiritide, has the pharmacological effects of expanding arteries and veins, diuresis of diuresis and lowering plasma aldosterone levels. In 2001, the U.S. FDA approved Nesiritide for the treatment of acute decompensated heart failure (HF). Completed prospective clinical trials such as VMAC and PRECEDENT have revealed their effectiveness in the treatment of HF. However, meta-analyzes suggest that rhBNP may lead to worsening renal function and increasing mortality. rhBNP is expensive and compared with inexpensive nitroglycerin, there is no difference in improving the overall clinical status of patients. Further evaluation of rhBNP in the treatment of HF remains to be seen in a multicenter, prospective, randomized, controlled clinical trial.