The Observation Of Clinical Curative Effect Of ANP Used In Patients Who Got Acute Heart Failure Or Acute Onset Of Chronic Heatr Failure

Objective: To prove efficacy and safety of rhANP（Recombinant HumanAtrial Natriuretic Peptide）in the treatment of acute heart failure or chronicheart failure acute onset.Testmethod and design: Random,placebo parallel controlled clinicaltrials.Cases sources: Cases from the patients of JiLin University First Hospitalafter the September2009.We selected those acute heart failure patients orchronic heart failure patients accord with acute attack clinical diagnosisstandard. We divided the patients into the treatment group and the controlgroup.Cases choice:Inclusion criterial:(1) acute heart failure or chronic heart failure acuteonset;(2)age18-75,female and male;(3)NYHA cardiac function hierarchicalIII-IV level;(4) left ventricular ejection fraction less than40%;(5)systolicblood perssure>90mmHg;(6)written informed agreement signed.Test group and treatment methods:Using the method of randomization, the cases are divided into thetreatment group and control group.One therapeutic group of20cases and onecontrol group of20cases.（1）The treatment group: The patients accepted the treatment of theheart sodium peptide(that is,rhANP)on the basis of the conventional treatmenton heart failure,rhANP starting dose is0.1ug/kg/min (namely:0.001ml/kg/min),continuously venous transfusion with venous pump the30min, then according to systolic blood pressure numerical value and heart failure clinicalsymptoms to adjust the dosage,dose to0.15ug/kg/min(namely:0.0015ml/kg/min),a total of60min medicine;（2）the control group: The patients accepted the placebo treatments onthe basis of conventional treatments on heart failure, the preparation methodof placebo is the same with the treatment group.（3）This research is finished after we observe two groups24hours frombegaining treatment, the third day for safety assessment,the28days follow-up.The observation index:Index of curative effect: vital signs (heart rate and breathing, bloodpressure), symptoms (cough pink frothy sputum,dyspnea, cough,cough upphlegm, fatigue, loss of appetite, abdominal distension, nausea, vomiting,chest pain, heart palpitations)，3-hour and12-hour urine volume，arterialblood gas analysis.Safety index: routine blood, urine and kidney function, hepatic function,blood fat, ion, arterial blood gas analysis, blood pressure monitoring ecg.Statistical methodThe statistical software SPSS13.0statistical analysis. Messuring materialuse x±s said, measurement data with t test, counting material with X2inspection. P <0.05is a statistical significance.Results:1、The efficacy index about heart failure treament of the treatment groupwas better than that of the control group, so It is effective to treat acute heartfailure and chronic heart failure acute onset using the heart sodium peptide2、The routine blood、 urine、liver and kidney function, blood fat, ion, bloodglucose are checked on patients in the treatment and the control group beforeand after treatment. The obvious and serious adverse reactions did not be found in each group.