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目的对顽固性心力衰竭患者实施冻干重组脑钠肽(rh-BNP,商品名:新活素)治疗的效果进行临床观察。方法对医院2010年2月-2014年10月收治的66例顽固性心力衰竭患者实施脑钠肽(BNP)治疗,观察治疗前后患者的血液动力指标、肺毛细血管楔压(PCWP)、中心静脉压(CVP)、右房压(RAP)以及左室射血分数(LVEF)等指标的情况。结果治疗后,本组患者的收缩压、舒张压均无显著的变化,相比治疗前差异无统计学意义(P>0.05)。心率用药1h后较治疗前明显下降(P<0.05),24h后心率恢复正常。PCWP用药、1h后较治疗前明显下降,1h之后,降幅趋于稳定,24~48h,PCWP保持在30mm Hg左右。治疗48h后LVEF较治疗前明显升高(P<0.05),血浆BNP浓度较治疗前无明显改善,差异无统计学意义(P>0.05)。结论采用BNP治疗顽固性心力衰竭,效果安全可靠。
Objective To observe the effect of freeze-dried recombinant brain natriuretic peptide (rh-BNP) on patients with refractory heart failure. Methods Sixty-six patients with refractory heart failure admitted to our hospital from February 2010 to October 2014 were enrolled in this study. BNP was measured before and after treatment. The hemodynamics, pulmonary capillary wedge pressure (PCWP), central venous pressure Pressure (CVP), right atrial pressure (RAP) and left ventricular ejection fraction (LVEF) and other indicators of the situation. Results After treatment, there was no significant difference in systolic pressure and diastolic pressure between the two groups. There was no significant difference between before and after treatment (P> 0.05). Heart rate after 1h significantly decreased compared with before treatment (P <0.05), 24h after heart rate returned to normal. PCWP medication, after 1h significantly decreased compared with before treatment, after 1h, the decline tends to be stable, 24 ~ 48h, PCWP remained at about 30mmHg. LVEF was significantly increased 48h after treatment (P <0.05), plasma BNP concentration was no significant improvement compared with that before treatment, the difference was not statistically significant (P> 0.05). Conclusion The treatment of refractory heart failure with BNP is safe and reliable.