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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[90s匀速静脉注射冲击量1.5μg/kg,0.0075μg/(kg·min)维持静脉注射48h]。应用USCOM无创血流动力学监测系统监测各组治疗前、治疗后30min、1、3、6、12、24和48h的血流动力学参数和48h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。
Objective: To study the efficacy of intravenous injection of recombinant human brain natriuretic peptide (rhBNP) in patients with acute myocardial infarction and heart failure. Methods: Eighty-one patients with acute myocardial infarction and heart failure hospitalized from August 2006 to August 2008 were randomly divided into routine treatment group (n = 43) and rhBNP treatment group (n = 38). Conventional treatment group: , Cardiac, diuretic, vasodilator therapy, rhBNP treatment group: rhBNP intravenous injection [90s constant intravenous injection of 1.5μg / kg, 0.0075μg / (kg · min) intravenous injection 48h] on the basis of routine treatment. USCOM noninvasive hemodynamic monitoring system was used to monitor the hemodynamic parameters of the groups before treatment, 30min, 1,3,6,12,24 and 48h after treatment, and the urine output, serum creatinine, serum potassium and serum sodium . Results: After administration of rhBNP, the peripheral vascular resistance (SVR) decreased (P <0.05), the stroke volume (SV), cardiac index (CI) and total urine volume (UR) 0.05), serum creatinine (CR) decreased compared with before treatment (P <0.05), compared with the conventional treatment group changes more significantly. CONCLUSION: Intravenous rhBNP in patients with acute myocardial infarction and heart failure has better hemodynamic and clinical effects than simple conventional therapy.