文章摘要
王芳芳,丁志坚,邹瑞秀,颜紫宁.重组人脑利钠肽治疗急性心肌梗死伴心力衰竭的疗效评价[J].南京医科大学学报,2009,29(3):372~
重组人脑利钠肽治疗急性心肌梗死伴心力衰竭的疗效评价
Therapeutic effects of recombinant human brain natriuretic peptide for the treatment of acute myocardial infarction complicated with heart failure
投稿时间:2008-08-23  
DOI:10.7655
中文关键词: 血流动力学  利钠肽,脑  心肌梗死  心力衰竭
英文关键词: hemodynamics  natriuretic peptide, brain  myocardial infarction  congestive heart failure
基金项目:常州市卫生局青年人才科技项目(QN200803)
作者单位
王芳芳 南京医科大学附属常州第二人民医院心内科,江苏 常州 213003 
丁志坚  
邹瑞秀  
颜紫宁  
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中文摘要:
      目的:研究静脉注射重组人脑利钠肽(rhBNP)治疗急性心肌梗死伴心力衰竭患者的疗效?方法:2006年8月~2008年8月住院的急性心肌梗死伴心力衰竭患者81例,随机分为常规治疗组(n = 43)和rhBNP治疗组(n = 38),常规治疗组:予病因?强心?利尿?扩血管治疗,rhBNP治疗组:常规治疗基础上加静脉注射rhBNP[90 s匀速静脉注射冲击量1.5 μg/kg, 0.0075 μg/(kg·min)维持静脉注射48 h]?应用USCOM无创血流动力学监测系统监测各组治疗前?治疗后30 min?1?3?6?12?24和48 h的血流动力学参数和48 h的尿量?血肌酐?血钾?血钠?结果:rhBNP静脉注射后外周血管阻力(SVR)较治疗前下降(P < 0.05), 每搏输出量(SV)﹑心脏指数(CI)﹑总尿量(UR)较治疗前升高(P < 0.05),血肌酐(CR)较治疗前下降(P < 0.05),较之常规治疗组的变化更明显?结论:急性心肌梗死伴心力衰竭患者静脉注射rhBNP较之单纯常规治疗有着更好的血流动力学效应和临床效果?
英文摘要:
      Objective:To evaluate the hemodynamic effects of intravenous injection of recombinant human brain natriuretic peptide (rhBNP) in patients with acute myocardial infarction complicated with heart failure by non-invasive cardiac output monitor. Methods:Eighty-one consecutive patients who suffered from acute myocardial infarction complicated with heart failure were divided into standard therapy plus rhBNP group(n = 38, 1.5 μg/kg bolus intravenous injection followed by 0.0075 μg/(kg·min) for following 48 hours) and standard therapy group(n = 43). The hemodynamic parameters were monitored by USCOM at baseline, and 0.5,1,3,6,12,24, 48 h during infusion. Results:In rhBNP group, systemic vascular resistance(SVR) was lower than the basic value(P < 0.05), stroke volume(SV), cardiac index(CI), total urine output(UR) was higher than the basic value(P < 0.05) and serum creatinine (CR) was lower than the basic value(P < 0.05); rhBNP group was markedly more effective than conventional treatment group. Conclusion:Intravenous injection of rhBNP combined with other routine treatments can further improve the hemodynamic effects in patients with acute myocardial infarction complicated with heart failure.
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