Treatment Of Acute Decompensated Heart Failure Clinical Evaluation Of Recombinant Human Brain Natriuretic Peptide

Objective: Evaluation of effect and security for recombine human B-type natriuretic peptide(rhBNP) curing acute decompensated heart failure(ADHF).Methods: 42 ADHF patients are randomly divided into two groups, the rhBNP group(n=21 cases) and the nitroglycerin(NTG) group(n=21 cases). The rhBNP group vein imparted rhBNP overloads dosage 1.5μg/kg in 90 seconds, keeps pumping with 0.0075μg/kg/min for 48 hours. The nitroglycerin(NTG) group vein pumped from 10μg/min, bases on patients clinical circumstances, can modulate dosage between 10-100μg/min(average dosage 45μg/min) for 48 hours. The two groups are both given furosemide 20-40mg/d in general during the period. The other vein cardiotonic or vas active medicine are not imparted during the research. Watching the progress echo-cardiogram fore and after medicine administration for 48 hours, contrast to SV,CO,LVEF. Progress evaluation of decompensation degree is carried out fore and after medicine administration for 48 hours. (Level for evaluation of decompensation degree:Ⅰhorizontal position;Ⅱnocturnal paroxysmal dyspnea;Ⅲsemireclining position;Ⅳorthopnea). We record the patients' variational circumstances of heart rate,blood pressure,monitoring patients' urine volume fore and after medicine administration for 48 hours, blood routine examination,routine uronoscopy,potassium(K~+) natrium(Na~+) chlorine(Cl~-) of blood,liver function,kidney function, also record patients' headache,bdelygmia,abdominal distention,hypotension etc these side-effect rate and the rate of malignant heart failure incidents in a week.Results: Experiment shows, aspect of decompensation straightens' up rate, group rhBNP 90.5%, group NTG 66.7%, group rhBNP obviously precedes than group NTG (p＜0.05); group rhBNP comparing with group NTG obviously increases in SV after treatment (p＜0.01). Group rhBNP comparing with group NTG obviously increases in CO after treatment (p＜0.01). Group rhBNP comparing with group NTG obviously increases in LVEF after treatment (p＜0.05); depending on interrelated medicine on side-effect side, two groups'discrepancy has no statistical meaning (p＞0.05).Conclusion:①rhBNP can obviously improve ADHF patients' difficulty level of respiratory, cutive effection is better than NTG.②rhBNP can obviously increase ADHF patients'SV,CO,LVEF, cutive effection is better than NTG.③rhBNP security conforms to NTG.