| BackgroundHeart failure is a serious threat to the safety of human life, thus more and more get people’s attention. And refractory heart failure is a terminal stage of various heart diseases development, due to its poor treatment effect, high case fatality rate, has become the difficulty of clinical treatment.In recent years, as people to the deepening of the research development of heart failure mechanism, the emphasis has shifted from improving hemodynamics change to antagonism excessive activation of neuroendocrine system, improve the ventricular remodeling, reduce hospitalization rate and mortality of patients.ObjectiveTo inestigate rhBNP curative effect and safety for the treatment of refractory heart failure.Methods56 cases of refractory heart failure patients from September 2014 to February 2015 in people’s hospital of zhengzhou university, NYHA heart function classification Ⅲ-Ⅳ level, left ventricular ejection fraction< 40%.29 males and 27 females,aged 53-79. In which 32 cases of coronary heart disease,10 cases of hypertensive heart disease,8 cases of rheumatic heart disease and 6 patients with DCM. These patients were randomly divided into two groups:observation group and control group, each group of 28 people. Exclusion object:cardiogenic shock, systolic blood pressure< 90 mmHg, severe valvular stenosis, restrictive cardiomyopathy, hypertrophic cardiomyopathy, constrictive pericarditis, malignant tumor and severe liver and kidney function is not complete, two groups of patients with basic data there was no significant difference.The patients of two groups were given conventional treatment of heart failure in resistance (diuretics, RAAS inhibitors, beta receptor antagonist, positive strength, water electrolyte disturbance, etc.),On the basis of the above treatment,the patients of observation group combined with rhBNP, put 0.5 mg into liquid of 50 ml, to 0.01 ug/(kg/min)-dose continued to trace pump pumping, with 72 hours in a row. After three days, evaluation of patients of two groups with the degree of difficulty in breathing, urine output, heart tate and blood pressure. And after seven days, monitoring serum NT-proBNP and NYHA heart function classification.Results1.After three days treatment, the rhBNP group of dyspnea score was 1.17±0.39, the urine output was (2835.00±642.78)ml/24h, the heart rate was (69.50±7.77) times/min, the systolic blood pressure was (110.79±12.61)mmHg, the diastolic blood pressure was (69.93±7.57) mmHg; the control group of dyspnea score was 2.11±0.69, the urine output was (1180±385)ml/24h,the heart rate was (68.36±8.22) times/min, the systolic blood pressure was (111.53±13.06)mmHg, the diastolic blood pressure was (70.71 ±1.13) mmHg.2. After seven days treatment, the rhBNP group of serum NT-proBNP reduced to (3676.14±1172.62)pg/ml, the clinical effect of the total effective rate was 96.43%; the control group of serum NT-proBNP reduced to (4435.07±1307.31)pg/ml, the clinical effect of the total effective rate was 64.28%.ConclusionRhBNP can effectively improve the clinical symptoms of patients with refractory heart failure and cardiac function, increase urine output significantly, decrease serum NT-proBNP. There is no obvious adverse reacton,it is safe and effective drug for treatment of refractory heart failure. |
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