Clinical Observation Of RhANP In The Treatment Of Heart Failure

Background and Objective:ANP （atrial natriuretie peptide，ANP） is akind of protein secreted by atrial organization, it has the natriuretic, diuresis,and relax effect on vascular muscle, and inhibit the effect of aldosterone, andparticipate in the pathophysiological events of cardiovascular system. ANPcombined with the receptors of guanylyl cyclase structure improve the level ofcGMP intracellular. The increased level of cGMP of the vascular tissue willcause the vasodilation. And that also cause the enhancement of the urine outputand urinary electrolyte, and increase blood flow and kidney glomerularfiltration rate（GFR）. The increased level of the ANP could make vasodilationnatriuresis and diuresis, so ANP is beneficial to the improvement of symptomsof acute heart failure patients.Mothods:40patients by standard with acute heart failure were involvedfrom June,2009to February,2012. The patients were received the rhANP0.1ug/（kg min）, baseline after30min, considering the systolic blood pressure andthe clinical symptoms of heart failure, adjusted the dose by0.15u g/（kg min）,and the total time was60min. All the patients were observed for24h,andrecorded the Respiration Rate,Blood Pressure,Oxygen Saturation,Blood GasAnalysis and UCG before and after the treatment.After3days of the treatmentwe recorded the Blood Biochemical Markers. After7days, as all patients werefollowed, collect the serious adverse event and other information. In thisresearch,all data were analyzed by statistical software SPSS19.0. Statisticalmethods: measurement data （mean±variance）,compares the measurement dataset in matching t test, p <0.05was considered statisticallly significant. Results: There were40patients used the rhANP. After3h,6h and12h,the heart rate were lower with significant difference （p <0.05） than that ofcontrol. But after30min,60min and24h, the heart rate were without significantdifference（p>0.05）than that of control. After30min,60min,3h,6h,12h and24h,the SBP were lower with significant difference （p <0.05） than that of control.After30min,60min,3h,6h,12h and24h, the DBP were lower with significantdifference （p <0.05） than that of control. After6h,12h and24h, the respiratoryrate were lower with significant difference （p <0.05） than that of control. Butafter30min,60min and3h,the respiratory rate were without significantdifference（p>0.05）than that of control. After30min,60min,3h,6h,12h and24h, the SPO2were without significant difference（p>0.05）than that of control.After used the rhANP3days, we gave the patients UCG examination, theLVEF%was higher with significant difference （p <0.05） than that of control.But the LAD and LVD were without significant difference（p>0.05）than that ofcontrol.After used the rhANP3hours, we have checked the arterial blood gasanalysis, the pH、PO2and PCO₂were without significant difference（p>0.05）than that of control. After used the rhANP3days, we have done the ECG, theQT Interval， QTC Interval and QRS Interval were without significantdifference（p>0.05）than that of control.After used the rhANP3days, all of the patients have done the laboratorytest, the RBC, Hb and PLT were higher with significant difference （p<0.05）than that of control. But the WBC, Hct, NEUT%and LYM%were withoutsignificant difference（p>0.05）than that of control. The TBIL was lower withsignificant difference （p<0.05） than that of control. But theAST, ALT, TP andAKP were without significant difference（p>0.05）than that of control. TheBUN, CREA and UA were without significant difference（p>0.05）than that of control. After3days,the CHOP, TP, HDL-C and LDL-C were withoutsignificant difference（p>0.05）than that of control. The K+was higher withsignificant difference （p<0.05） than that of control. The Cl—was lower withsignificant difference （p<0.05） than that of control.And the Na⁺, Ca²⁺, TCO₂and CRP were without significant difference（p>0.05）than that of control.After used the rhANP3days, all of the patients have done the urine routine test,the PRO, GLU, HRBL（/HP） and HWBC（/HP） were without significantdifference（p>0.05）than that of control.There were3cases of adverse events during this study, they were all lowblood pressure, which happened during1h, but without special treatment theblood pressure became normal. There were no serious adverse events duringthis study.Conclusions: rhANP can cause the heart rate, blood pressure andrespiration rate declined obviously, it can improve the left ventricular ejectionfraction, but Blood Biochemical Markers and ECG have no significant effect.It’s efficacy and safety on Clinical use.