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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2009年第3期

页码:

387-389

栏目:

临床研究

出版日期:

2009-05-15

文章信息/Info

Title:

Effects of recombinant human brain natriuretic peptide on hemodynamics and neurohumoral factors of patients with chronic heart failure

作者:

张青¹; 葛海龙²; 周玉杰²

1.青海省第五人民医院心内科,青海 西宁 810007；2.首都医科大学附属北京安贞医院心内科，北京 100029)

Author(s):

ZHANG Qing¹;  GE Hai-long²;  ZHOU Yu-jie²

1.Department of Cardiology, Fifth People Hospital of Qinghai, Xining 810007, Qinghai, China; 2.Department of Cardiology, Beijing Anzhen Hospital, Carital University of Medical Science, Beijing 100029, China

关键词:

重组人脑钠尿肽; 心力衰竭; 血流动力学; 神经体液因子

Keywords:

recombinant human brain natriuretic peptide;  chronic heart failure;  Hemodynamics;  Neurohumoral factors

分类号:

R541.641

DOI:

-

文献标识码:

A

摘要:

目的 评价重组人脑钠尿肽(rhBNP）治疗慢性心力衰竭(CHF)的疗效。方法 CHF患者53例，分为rhBNP组23例和对照组30例。观察两组用药前后右房压（RAP）、肺毛细血管楔嵌压(PCWP)、肺动脉压（PAP）、心脏指数（CI）、血浆去甲肾上腺素(NE)、血管紧张素Ⅱ（AngⅡ）及醛固酮（Ald）的变化。结果 rhBNP在降低RAP，PCWP，PAP，NE，AngⅡ及Ald等指标方面与对照组和本组治疗前比较均有统计学差异。对CI、血钠、血钾无明显影响。无明显不良反应。结论 rhBNP可改善CHF患者血流动力学状况，拮抗NE，AngⅡ，Ald的过度激活，较为安全。

Abstract:

AIM To evaluate the effects of recombinant human brain natriuretic peptide( rhBNP) in the treatment of patients with chronic heart failure. METHODS 53 cases of chronic heart failure were randomly divided into the group treated with rhBNP and ordinary heart failure medication (23 cases) and the control group only treated with ordinary heart failure medication (30 cases). Right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP), cardiac index (CI) and plasma norepinephrine, angiotensin II, aldosterone were recorded at different time points before and after medication. RESULTS RhBNP in the reduction of RAP, PCWP, PAP, plasma norepinephrine, angiotensin II, aldosterone and after rhBNP medication in the treatment group and there changes between rhBNP group and control were also significant(P<0.05). Thecardiacindex,serumsodium, putassium no significant impact. No significant adverse effect was found. CONCLUSION rhBNP improved hemodynamic status in patients with chronic heart failure and inhibited over activation of plasma norepinephrine, angiotensin II, aldosterone.

参考文献/References

[1］ Karl S, John C, Wislson S, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary［J］. Eur Heart J, 2005, 26(6):23-27.

［2］ Iton H, Nekao K, Saito Y, et al. Radioimmunoassay for brain natriuretic peptide (BNP): Detection of BNP in canine［J］. Biochem Biophys Res Commun, 1989, 158(1):120-128.

［3］ Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain［J］. Nature, 1988, 332(6159):78-81.

［4］ Hosoda K, Nakao K, Mukayama M, et al. Expression of brain natriuretic peptide gene in human heart production in the ventricular［J］. Hypertension, 1991, 17(6):1152-1155.

［5］ Stein BC, Levin RL. Natriuretic peptides physiology therapeatic potential, and risk stratification, in ischemic heart disease［J］. Am Heart J, 1998, 135(5):914-923.

［6］ Brunner-La Rocca HP, Kaye DM, Woods RL, et al. Effects of intravenous brain natriuretic peptide on regional sympathetic activity in patients with chronic heart failure as compared with healthy control subjects［J］. J Am Coll Cardiol, 2001, 37(5):1221-1227.

［7］ Yong J, Abram WT, Stebvenson LW, et al. Results of the VMAC trail(Vasodilation in the management of acute congestive heart failure［J］. Circulation, 2000, 102(5)：2794-2795.

［8］ Wang DJ, Dowling TC, Meadows D, et al. Nesiritide does not improve function in patients with chronic heart failure and worsening serum creatinine［J］. Circulation, 2004, 110(12):1620-1625.

［9］ Sackner-Bernstein JD, Skopicki HA, Aaronson KD. Risk of worsening renal fuction with nesiritide in patients with acutely decompensated heart failure［J］. Circulation, 2005, 111(12):1487-1491.

备注/Memo

备注/Memo:

收稿日期：2007-12-29.作者简介：张青，副主任医师Email:zhq9900@163.com

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更新日期/Last Update: 2009-05-18