重组人脑利钠肽对顽固性心力衰竭患者的血液动力学影响及疗效研究(1)
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[摘要] 目的 观察冻干重组人脑利钠肽(新活素)对顽固性心力衰竭患者的血液动力学影响及临床效果。 方法 收集顽固性心力衰竭患者98例，监测和比较新活素治疗前后血液动力学参数、生化和临床指标。结果 顽固性心力衰竭患者接受新活素治疗后，心率和肺毛细血管楔压显著下降，心脏指数显著升高，呼吸困难、心功能和全身临床状况显著改善，尿量显著增多，血浆脑利钠肽浓度显著下降，未发现与新活素相关的症状性低血压及其他严重不良反应。结论 新活素治疗顽固性心力衰竭有着较好的血流动力学效应和临床效果，且安全可行。
[关键词] 重组人脑利钠肽；顽固性心力衰竭；血液动力学；临床疗效；安全性
[中图分类号] R541.6+1 [文献标识码] B [文章编号] 1673-9701(2012)04-0039-03
Hemodynamic effects and efficacy of recombinant human brain natriuretic peptide in the patients with refractory heart failure
QIAN Songquan1 HUYongqi1 RUAN Zhanwei1 ZHENG Xudong1 KUANG Yongdong2 YE Xiangyang2
1.Departmen of Emergency, Ruian People’s Hospital in Zhejiang Province (the Third Affiliated Hospital of Wenzhou Medical College), Ruian 325200, China； 2. Department of Cardiology，Ruian People’s Hospital in Zhejiang Province (the Third Affiliated Hospital of Wenzhou Medical College), Ruian 325200, China
[Abstract] Objective To observe hemodynamic effects and efficacy of recombinant human brain natriuretic peptide (rhBNP) in the patients with refractory heart failure. Methods Ninty-eight consecutive patients with refractory heart failure were enrolled into this study. The hemodynamic parameters, blood variables and clinical changes between post- and pre- infusion were monitored and compared. Results After rhBNP infusion, pulmonary capillary wedge pressure and heart rate were significantly reduced, cardiac index was increased obviously, Improvement in dyspnea grade, patient’s symptoms and signs, and heart function was significant, the total urine output were enhanced significantly and blood brain natriuretic peptide concentrations were also decreased. There was no symptomatic hypotension or other adverse events during infusion. Conclusions Intravenous injection of rhBNP results in effective hemodynamic improvements and good clinical efficacy, and is also feasible and safe for clinical use in the patients with refractory heart failure.
[Key words] Recombinant human brain natriuretic peptide; Refractory hear failure; Hemodynamics; Efficacy; Safety
顽固性心力衰竭治疗困难，预后差。重组人脑利钠肽(又名新活素)是一种人工合成的多肽类心脏神经激素,具有扩张血管、利尿利钠、有效降低心脏前后负荷、抑制肾素-血管紧张素-醛固酮系统和交感神经系统等作用[1-4]。新活素治疗急性心力衰竭在临床上取得了较满意的效果[5-7] ......
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