同济大学学报（医学版）2012，Vol.33Issue(2)：87-90,94,5.DOI:10.3969/j.issn1008-0392.2012.02.021
脑钠肽对充血性心力衰竭患者恶性心脏事件发生的影响
Brain natriuretic peptide reduces incidence of adverse cardiac events in patients with congestive heart failure
高菲 1金惠根 1刘宗军 1王大英 1蒋金法2
作者信息
- 1. 上海中医药大学附属普陀医院心内科,上海200062
- 2. 同济大学附属同济医院心内科,上海200065
- 折叠
摘要
Abstract
Objective To investigate the effect of B-type natriuretic peptide(BNP) on incidence of adverse cardiac events in patients with decompensated congestive heart failure (CHF). Methods One hundred and forty patients with CHF were randomly assigned to routine therapy ( digoxin, diuretic, β-receptor blocker and ACEI, n =74) or BNP therapy (routine therapy plus BNP I. V. , n = 66). The improvement of symptoms was defined according to the cardiac function standard of New York Heart Association (NYHA). All patients underwent two-dimensional pulsed Doppler echocard-iography to measure the cardiac volume parameters (left ventricular end-diastolic volume, LVEDV; left ventricular end-systolic volume, LVESV) and the left ventricular ejection fraction (LVEF). Patients were followed up for 10 months, and adverse cardiac events were defined as rehospitalization or/and death due to cardiac factors and malignant arrhythmia (ventricular tachycardia or fibrillation). Results In 66 patients receiving BNP 60 had a good therapeutic effect with an effective rate 90. 9% and in control group, 63 had a good therapeutic effect with an effective rate 85. 1% (P < 0. 05). Rehospitalization due to cardiac factors was occurred in 10 patients of BNP group and 15 of control group(P <0.05). Five patients in BNP group died due to cardiac factors and 7 died in control group (P > 0. 05). LVESV and LVEF were improved after treatment in both groups (P < 0. 05), but the improvement of LVESV, LVEDV and LVEF in BNP group was more markedly than that in control group(P <0. 05). Patients in both groups had improvement of symptoms with decreasement of heart rate and blood pressure, and there was no significant difference between two groups(P >0.05). With 10 months follow-up, 80. 3% patients in BNP group had a better cardiac function and improvement of symptoms, especially patients with NYHA Ⅱ and Ⅲ, the improvement was significantly(P <0. 01) , however, patients with Ⅳ, the symptoms were not improved significantly(P >0. 05). Conclusion BNP may improve symptoms of patients with CHF and it may also reduce incidence of adverse cardiac events.关键词
脑钠肽/慢性心力衰竭/心脏不良事件Key words
brain netriuretic peptide/ congestive heart failure/ adverse cardiac events分类
医药卫生引用本文复制引用
高菲,金惠根,刘宗军,王大英,蒋金法..脑钠肽对充血性心力衰竭患者恶性心脏事件发生的影响[J].同济大学学报（医学版）,2012,33(2):87-90,94,5.
