Abstract
Objective To investigate the efficacy and prognosis of recombinant human brain natriuretic peptide in elderly patients with acute decompensated heart failure .Methods Ninety-two cases of elderly patients with acute decompen-sated heart failure were selected , they were treated in hospital from February 2015 to February 2016 , and they were divided into the observation group (46 cases) and control group (46 cases).The patients of two groups were all treated with standard practice for anti-heart failure, include maintaining the smooth flow of the respiratory system , oxygen, low sodium salt diet, correct electrolyte imbalance, and given ACEI, diuretic, cardiac, vasodilators and inotropic drugs.The patients of control group were treated with nitroglycerin ( dissolved in 5%sodium chloride solution for intravenous infusion , the initial dose of the first day were 10 μg /min, increase 5μg /min in every 5min until 40 μg /min, and keep 5 mg /d continuous intravenous infusion for 4d), and on the basis of the control group , the patients of observation group were treated with recombinant human brain natriuretic peptide (the initial dose was 1.5 μg /kg for intravenous pulse shock treatment , then keep 0.0075 μg· kg-1 · min-1 ) continuous intravenous infusion for 24 h, and keep 0.5 mg/d (0.0075μg· kg-1 · min-1 ) intermittent treat-ment for 4d.The patients of two groups were all treated for 6 months in a row.The clinical effect, safety evaluation and chan-ges of the levels of LVESD , LVEDD, LVEF, CRP, BNP, 24h urine output of two groups were compared .Results After the appropriate treatment , the patients of the observation group got a total effective rate of 95 .7%, which was significantly better than the 82.6%of the control group(χ2 =4.039, P =0.044);The levels of LVESD, LVEDD, CRP, BNP of the observation group were significantly lower than those of the control group ( t =2.739, t =2.253, t =3.897, t =5.162, P =0.004, P =0.013, P =0.002, P =0.000);The levels of LVEF, 24h urine output of the observation group were significantly higher than those of the control group( t =9.722, P =0.000);There were headache, abdominal pain, orthostatic hypotension, ele-vated serum potassium , elevated transaminase and other adverse reactions occurred in both two groups , but there were no sta-tistically significant between the two groups (χ2 =0.177,χ2 =2.222,χ2 =0.956,χ2 =0.474,χ2 =1.593, P =0.674, P =0.136, P =0.328, P =0.491, P =0.207).Conclusion With treating elderly patients with acute decompensated heart failure, recombinant human brain natriuretic peptide can obtain the exact effect , effectively relieve the clinical symptoms , im-prove the ventricular remodeling , improve the heart function, and it is safe, reliable and conducive to the prognosis of patients .关键词
重组人脑利钠肽/心力衰竭,急性失代偿/临床疗效/心功能/脑钠肽Key words
Recombinant human brain natriuretic peptide/Heart failure/acute decompensated/Efficacy/Cardiac function/Brain natriuretic peptide
