摘要
目的评价新活素两种不同给药方法治疗急性左心衰竭(ALHF)的短期疗效与预后。方法入选解放军第二五五医院于2012年1月1日~2013年12月31日连续住院的急性左心衰竭成年患者161例,按随机分组数字表随机分至试验组和对照组。在基础治疗同时分别按常规方法(对照组)和直接维持量方法(试验组)使用新活素治疗72 h,随访3个月。比较两组在临床表现、血流动力学指标、心力衰竭(心衰)标志物、以低血压为主的不良反应和终点事件等方面的差异,以及在药品使用数量和相关医药费等方面的区别。结果治疗前后两组间在临床表现(呼吸频率、呼吸困难症状缓解时间、24 h尿量)、血流动力学指标(HR、SBP、LVEF)、心衰标志物(NT-proBNP)等方面差异无统计学意义(P>0.05)。两组间以低血压为主的不良反应发生率分别为8.6%和22.5%,试验组低血压反应发生率和药品使用数量、相关医药费明显降低,差异有统计学意义(P<0.05)。主要和次要终点事件发生率差异无统计学意义(P>0.05)。结论两种方法治疗急性左心衰竭的短期疗效相当,新活素直接维持量给药的方法可降低低血压不良反应发生率,并降低药品使用数量和相关医药费。
Objective To review the short-term curative effect and prognosis of recombinant human brain natriuretic peptide （rhBNP） in 2 administration ways in treatment of acute left heart failure （ALHF）. Methods The patients with ALHF were chosen （n=161） from the Chinese PLA 255th Hospital from Jan. 1, 2012 to Dec. 31, 2013, and then randomly divided into test group and control group. On the base of basic treatment, the control group was treated with routine therapy and test group was treated with rhBNP in a direct dose-maintaining manner for 72 h, and 2 groups were followed up for 3 m. The clinical manifestations, hemodynamic indexes, heart failure markers, adverse reactions （mainly hypotension） and end-point events, meanwhile the differences in quantity of drugs and relevant medical fees were compared between 2 groups. Results The difference in clinical manifestations （respiratory rate, remission time of dyspnoea and 24 h urine volume）, hemodynamic indexes （HR, SBP and LVEF） and heart failure markers （NT-proBNP） had no statistical significance between 2 groups before and after treatment （P〉0.05）. The incidence of adverse reactions （mainly hypotension） was 8.6% in test group and 22.5% in control group. The incidence of hypotension, quantity of drugs and relevant medical fees decreased significantly in test group （P〈0.05）. The difference in the incidence of major and secondary end-point events had no statistical significance between 2 groups （P〉0.05）. Conclusion The both administration ways have the similar short-term curative effect in treatment of ALHF. The direct dose-maintaining manner of rhBNP can reduce the incidence of hypotension, quantity of drugs and relevant medical fees.
出处
《中国循证心血管医学杂志》
2017年第5期584-587,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
新活素
急性左心衰竭
低血压
不良反应
前瞻性研究
Recombinant human brain natriuretic peptide
Acute left heart failure
Hypotension
Adverse reactions
Prospective study
