天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (6): 789-792.doi: 10.11958/20150272

• 药物临床观察 • 上一篇    下一篇

左西孟旦与重组人脑利钠肽治疗急性失代偿性心力衰竭效果对比研究

吴淑彬， 丁力平， 靳志涛， 张丽娟， 张铮， 康凤池， 张连， 胡桃红   

  1. 辽宁医学院中国人民解放军第二炮兵总医院研究生培养基地心内科 （邮编 100088）
  • 收稿日期:2015-10-30 修回日期:2016-01-10 出版日期:2016-06-15 发布日期:2016-07-04
  • 基金资助:
    国家自然科学基金资助项目 （81400274）

Comparison of efficacies of levosimendan and recombinant human brain natriuretic peptide in patients with acute decompensated heart failure

WU Shubin, DING Liping, JIN Zhitao, ZHANG Lijuan, ZHANG Zheng, KANG Fengchi, ZHANG Lian, HU Taohong   

  1. Department of Cardiology, The Second Artillery General Hospital, Liaoning Medical University, Beijing 100088, China
  • Received:2015-10-30 Revised:2016-01-10 Published:2016-06-15 Online:2016-07-04

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摘要： 摘要： 目的 对比左西孟旦（Levo）和重组人脑利钠肽（rhBNP）治疗急性失代偿性心力衰竭（ADHF）的效果。方法 选取 75 例 ADHF 患者， 随机均分入实验组（Levo 组、 rhBNP 组）及对照组（多巴酚丁胺组）。观察并比较 3 组患者用药 72 h 后心率、 呼吸频率、 24 h 尿量、 6 分钟步行距离改善情况及用药 1 周后血浆脑利钠肽 （NT-proBNP）、 左室舒张末期内径 （LVEDD） 以及左室射血分数 （LVEF） 变化情况。结果 用药 72 h 后各组心率及呼吸频率均降低、 24 h 尿量及 6 分钟步行距离均增加 （P < 0.05）； 用药 1 周后各组 NT-proBNP 均下降、 LVEF 均上升 （P < 0.05）， 但治疗前后 LVEDD 无明显改变 （P > 0.05）； 治疗后， Levo 组与 rhBNP 组上述指标改善程度较多巴酚丁胺组更明显 （P < 0.05）， 但 Levo 组与 rhBNP 组比较差异无统计学意义。常见不良反应为低血压、 室性早搏， 各组不良事件发生率差异无统计学意义。结论 与多巴酚丁胺相比， Levo 与 rhBNP 治疗 ADHF 效果确切， 不良反应少， 安全性良好， 值得推广应用。

关键词: 心力衰竭, 左西孟旦, 重组人脑利钠肽, 多巴酚丁胺, 血浆脑利钠肽, 左室舒张末期内径, 左室射血分数

Abstract: Abstract： Objective To compare the effects of levosimendan (Levo) and recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF). Methods Seventy-five patients were included into this randomized positive-controlled and parallel-group study to receive either Levo (Levo group), rhBNP (rhBNP group) or dobutamine therapy (control group). Heart rate, respiratory rate, 24-hour urine volume， improvement in six-minute walktest after 72-h treatment were compared between three groups. The blood level of BNP and values of left ventricular end dia⁃ stolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) after one- week treatment were compared between three groups. Results After 72-h treatment, heart rate and respiratory rate were significantly decreased, and 24-hour urine volume, six-minute walk-test were significantly increased in three groups (P < 0.05). The NT-proBNP and LVEF were im⁃ proved after one week treatment (P > 0.05), but the LVEDD was improved barely (P > 0.05). The improvements were more significant in Levo group and rhBNP group compared to those of control group (P < 0.05). There were no significant differenc⁃ es in improvements between Levo group and rhBNP group. The common adverse reactions were hypotension and ventricular premature beats. There were no significant differences in adverse event rates between three groups (P < 0.05). Conclusion As compared with dobutamine, Levo and rhBNP have optimized efficacy, fewer side effects and good safety in the treatment of ADHF. They are worth of clinical application.

Key words: heart failure, levosimendan, recombinant human brain natriuretic peptide, dobutamine, brain natriuretic peptide, left ventricular end-diastolic diameter, left ventricular ejection fraction