【摘要】 目的　研究国产重组人脑钠肽 (rhBNP)对慢性心衰犬血流动力学及肾功能的影响。方法　用右心室快速起搏 (RVP)或狭窄下腔静脉 (TIVCC)形成犬的心衰模型。结果　RVP心衰犬ivrhBNP后 ,平均动脉压 (MAP)、左室内压 (LVSP)、LVdp dt、肺动脉压 (PAP)、左室舒张末期压 (LVEDP)、总外周阻力 (TPR)及肾血管阻力 (RVR)呈剂量依赖性下降 ,LVdp dt P、左室做功 (LVW )、心输出量 (CO)和心率 (HR)无明显改变 ;TIVCC心衰犬在iv同剂量rhBNP后 ,MAP ,LVEDP和CO下降 ,其他心功能指标无明显改变。两种心衰犬给药后尿量和尿钠排出量均增加。结论　rhBNP有舒张血管和利尿作用 ,能明显降低心衰犬的心脏前后负荷 ,不影响心脏收缩功能。更多还原

【Abstract】 AIM To study the effects of rhBNP on the cardiac hemodynamics and renal function in dogs with heart failure. METHODS Congestive heart failure in dogs was induced by either rapid ventricular pacing (RVP), 250 beats·min -1 for 7～14 days or by thoracic inferior vena cava constriction (TIVCC) to 1/2 its original diameter. When remarkable hemodynamic changes appeared rhBNP was infused intravenously at the dosage of 10, 30 and 100 ng·kg -1 ·min -1 , each dose lasting 30 min. RESULTS In dogs ( n =7) with RVP heart failure, intravenous infusion of rhBNP at 10～100 ng·kg -1 ·min -1 , caused decreases in mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), LVdP/dt max , pulmonary arterial pressure (PAP), left ventricular end diastolic pressure (LVEDP), total peripheral vascular resistance (TPR) and renal vascular resistance (RVR) dose dependently, without significant changes in cardiac output (CO), LVdp/dt/P, left ventricular work (LVW), renal blood flow (RBF) and heart rate (HR). This suggested that rhBNP reduced the pre load and after load of the dogs with congestive heart failure but showed no distinct effect on the contractility of the heart. In dogs ( n =7) with TIVCC heart failure, there were remarkable decreases in MAP and LVEDP following the rhBNP infusion, without further reduction of CO, but no marked change in HR, LVSP, LVdP/dt max , RAP and TPR. In both animal models of heart failure, there were significant increases in urine volume and sodium excretion which were more significant in TIVCC dogs than in RVP dogs. CONCLUSION rhBNP reduced the pre load and after load in dogs with heart failure and showed remarkable diuretic effect, but did not affect the contractility of the heart.更多还原