摘要
目的观察基因重组人脑利钠肽(rhBNP)治疗心力衰竭伴肺动脉高压的效果。方法 40例心力衰竭伴肺动脉高压患者,随机分为静脉滴注rhBNP组和对照组,每组20例。两组患者均给予降低肺动脉压及改善心功能等基础治疗。比较用药前及用药48 h后两组患者有创血流动力学参数、左心功能、肺动脉压、不良反应和治疗2周内的主要不良心脏事件(MACE)的发生情况。采用SPSS 15.0软件处理;计量资料采用配对t检验,计数资料用χ~2检验,P<0.05为差异有统计学意义。结果 rhBNP组和对照组间及用药前后中心静脉压(CVP)和收缩压(SBP)无明显变化。rhBNP组用药48 h后的肺毛细血管楔压(PCWP)较对照组明显降低(P<0.05)。2周后,rhBNP组左室射血分数及肺动脉压较对照组显著改善(P<0.05)。本研究未发现严重不良反应,仅发现1例与rhBNP相关的症状性低血压。两组治疗2周内的主要心血管事件的发生情况相似。结论对于心力衰竭伴肺动脉高压患者,滴注rhBNP可降低PCWP,改善心功能,可明显改善患者症状,但不影响血流动力学,是安全有效的治疗心力衰竭伴肺动脉高压的药物。
Objective To investigate the effects and safety of nesiritide,i.e.,a recombinant human Btype natriuretic peptide(rhBNP) in patients with pulmonary hypertension complicated with heart failure.Methods Hospitalized patients with pulmonary hypertension complicated with heart failure(40 cases)were randomly divided into rhBNP-treated group(n=20) and no treatment control group(n=20).The two groups both received the basic treatment to decrease pulmonary hypertension,improve heart function.The hemodynamic parameters were monitored using Swan-Ganz catheter before and at 48 hours after drug infusion.The major adverse cardiac events(MACE),pulmonary artery pressure(PAP) and left ventricular ejection fraction(LVEF) were monitored up to 2 weeks after drug infusions.Results Central venous pressure and systolic blood pressure were unchanged with or without rhBNP infusion.Compared to the control group without infusion,PAP of the rhBNP-treated group was significantly reduced after treatment.After 2 weeks,LVEF and PAP of the rhBNP-treated group significantly improved,in comparison to the group.Other than 1 case of rhBNP associated symptomatic hypotension,no adverse events were observed during drug infusion.MACE up to 2 week post drug infusion was also similar to that of the untreated control.Conclusions In patients hospitalized with pulmonary hypertension complicated with heart failure,nesiritide improves hemodynamic function and clinical status,and deceases PCWP.Therefore,nesiritide is effective and safe for the treatment of pulmonary hypertension complicated with heart failure.
出处
《慢性病学杂志》
2015年第6期623-625,629,共4页
Chronic Pathematology Journal
关键词
心力衰竭
肺动脉高压
脑利钠肽
血流动力学
Heart failure
Pulmonary hypertension
Natriuretic peptide,brain
Hemodynamics
