摘要
目的:观察重组人脑钠肽(rh BNP)间歇给药方式治疗急性失代偿性心力衰竭(ADHF)的临床疗效。方法:选择90例ADHF患者,随机分为观察组和对照组,每组45例。观察组采用rh BNP间歇性给药治疗方式,在常规治疗的基础上,给予0.0075~0.010μg/(kg·min)的rh BNP(0.5 mg的rh BNP用生理盐水稀释至83.3 m L)持续静脉滴注;对照组采用rh BNP常规给药方式,将rh BNP 0.5 mg用生理盐水稀释至83.3 m L,给予静脉缓慢推注,时间为10min,再予以0.0075~0.010μg/(kg·min)rh BNP持续静脉滴注。观察2组患者的临床疗效及心率、尿量、平均动脉压、心功能及血浆脑钠肽(BNP)水平的变化。结果:观察组的总有效率明显高于对照组(91.1%vs 46.7%,P<0.05);2组患者治疗前平均心率、平均尿量、平均动脉压的比较差异无统计学意义(P>0.05)。与治疗前比较,2组患者治疗后的平均心率明显减慢、平均尿量显著增加、平均动脉压均降低(均P<0.05),观察组治疗后的平均心率低于对照组,平均尿量多于对照组,但差异无统计学意义(P>0.05);治疗后2组患者左室射血分数(LVEF)均显著增加,血浆BNP水平均明显下降,且观察组的LVEF高于对照组,血浆BNP水平低于对照组(均P<0.05)。结论:采用rh BNP间歇给药方式治疗ADHF患者的疗效显著,能有效降低疾病的发生率,是一种安全可行的治疗方法。
Objective： To investigate the clinical effect of intermittent rh BNP administration in the treatment of ADHF.Methods： Nintey patients with ADHF were divided into observation group（ n = 45） and control group（ n = 45）. The observation group was treated by intermittent administration of rh BNP,and the control group by routine administration of rh BNP.The clinical effects,heart rate,urine volume,mean arterial pressure,cardiac function and plasma BNP levels were observed before and after treatment. Results： The total effective rate in the observation group was significantly higher than that in the control group（ 91. 1% vs 46. 7%,P 〈 0. 05）. There was no significant difference in mean heart rate,mean urine volume and mean arterial pressure between the two groups before treatment（ P 〉 0. 05）. The average heart rate in the two groups after treatment was significantly slowed down,the average urine volume increased significantly and mean arterial blood pressure decreased as compared with those before treatment（ all P 〉 0. 05）. The average heart rate after treatment in the observation group was lower than the control group,and the average urine volume was more than the control group,but there was no significant difference（ P 〉 0. 05）. After treatment,the LVEE in the observation group and the control group was significantly increased,and the plasma BNP levels were significantly decreased. LVEE in the observation group was higher,and plasma BNP levels were lower than in the control group with the difference being statistically significant between two groups（ P 〈 0.05）. Conclusion： rh BNP intermittent administration in patients with ADHF obtains significant effect,can effectively reduce the incidence of the disease,and is a safe and feasible treatment.
出处
《内科急危重症杂志》
2017年第3期221-223,共3页
Journal of Critical Care In Internal Medicine
