【摘要】 目的评价扩张型心肌病(DCM)患者发生重度失代偿性心力衰竭时应用重组人脑利钠肽(rh BNP)的疗效及安全性。方法68例临床诊断为扩张型心肌病合并重度失代偿性心力衰竭患者,按照随机化的原则,将其分为对照组(34例)和治疗组(34例),在常规抗心衰治疗的基础上,分别给予硝普钠和重组人脑利钠肽。观察两组临床疗效、心功能改善情况及NT-pro BNP水平、平均住院时间及不良反应。结果治疗5天后,治疗组临床症状明显改善(治疗组总有效率86%、对照组总有效率70%)、左室射血分数(LVEF)上升(治疗组16.9%、对照组11.1%),左室收缩末内径缩小(治疗组0.95mm、对照组0.66mm),左室舒张末内径缩小(治疗组1.16mm、对照组0.86mm),每分钟排血量(CO)增加,NT-pro BNP明显下降,6分钟步行距离延长,平均住院时间缩短,两组差异具有统计学意义(P<0.05),两组均无明显不良反应。结论 rh BNP治疗扩张型心肌病伴重度失代偿性心力衰竭患者,有效改善临床症状,缩短平均住院时间,安全有效,值得基层医院临床应用。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide(rh BNP) in treating of dilated cardiomyopathy(DCM) patients in seere decompensated heart failure. Methods 68 cases of DCM with severe decompensated heart failure patients were randomly allocated to control group(34 cases) and treatment group(34 cases). In addition to the standard anti-heart failure therapy, Sodium nitroprusside and rh BNP was added to control group and treatment group respectively as adjuvant therapy to these patients. Clinical efficacy, improving of cardiac function and NT-pro BNP level, the average length of hospital stay and adverse reactions are recorded in the two groups. Results 72 hours after treatment, clinical symptoms significantly improved in treatment group(total effective rate was 86% and 70% in treatment group and control group respectively), left ventricular ejection fraction(LVEF) increased 16.9%(16.9% in treatment group and 11.1% in control group), left ventricular end-systolic dimension narrowed(0.66 mm in treatment group and 0.95 mm in control group), left ventricular end-diastolic diameter narrowed(1.16 mm in treatment group and 0.86 mm in control group), per minute cardiac output(CO) increased, NT-pro BNP decreased obviously, the 6-minute walk test improved, and average hospitalization time shorten. The difference between the two groups was statistically significant(P<0.05), and other adverse events did not occur in both groups. Conclusion Rh BNP treatment of dilated cardiomyopathy(DCM) patients in seere decompensated heart failure, improve clinical symptoms and shorten the average hospitalization time, safely and effectively. It is worth widely applying in the primary hospitals.更多还原