| Recombinant human brain natriuretic peptide(rhBNP)(trade name:rhBNP)is produced by Chengdu Nuodikang pharmaceutical factory,Shenzhen cityin the national China kangzhe pharmaceutical exclusive sales agent of a class of drugs,in recent years,it has a good performance in the treatment of heart failure,each big authoritative literature recommendation timely use of this drug for the treatment of heart failure the.The new active with the amino acid sequence and spatial configuration of the same andendogenous BNP.April 10,2005,approved by the State Food and drug administration,the country a class of drugs the Xinhuosu access to new drug certificate(country medicine accurate word S200502237 date),in order to further observe and confirm the new active safety and efficacy ofTM in treatment of acute decompensated heart failure and acute attack of chronic heart failure in a wide range of conditions,explore dose compliancesex,recommend the best regimen.The first test is divided into two parts,respectively,different administration time differences on curative effect and different dosage effect.Object testselected for dyspnea at rest or with minimal activity in acute decompensatedheart failure or acute attack of chronic heart failure in 205 patients,were randomly divided into four groups,the first intravenous impact,according to 1.5?g/kg intravenous injection,injection time of 3?5 minutes,then by the 0.0075?0.01 g/kg/min dose intravenous infusion of 24 or 48 hours.Intravenous not given for many drugs for treatment of patients,according to 0.01?g/kg/min or 0.015 p.g/kg/min intravenous drip,recommend 1 to 2 times a week,continuous treatment for 3 months.The observation time including the follow-up of 30 days 24 or 48hours of treatment time and after stopping drug,on patients with dyspnea,NT-proBNP to improve the situation,improve the hemodynamics,body condition,24 hour urine volume,to evaluate the therapeutic effect of cardiovascular events.Experimental results show that brain natriuretic peptide with 0.015?g/kg/min speed of intravenous infusion of 48h the effect of the treatment of acute heart failure is better than the other three groups(0.01?g/kg/min-48 h,0.015?g/kg/min-24 h);so the final is in patients with less adverse reactions of dose,the best dosage schedule in 48 hours of intravenous injection rate of 0.015?gFor the symptomatic treatment of acute heart failure has made substantial progress in the past 30 years,since the seventy's,the significant change inhemodynamics decompensated heart failure hospitalization drug treated patients,few large progress in recent years.Heart failure is a complexdisease,is a serious stage of various heart disease development,and the incidence rate is rising year by year,the survival rate is very low,typically 3?5 years.And cancer,harm the health of people is very large.So thefailure of timely and effective treatment is very important,not only can give the good prognosis patients,but also reduce the patients duringhospitalization and mortality,so as to reduce the burden for patients.At present,the standard treatment for severe decompensated heart failuremainly includes:intravenous diuretics,adrenergic drugs(such asdobutamine),phosphodiesterase inhibitors(such as milrinone)and nitratevasodilator drugs(such as nitroglycerin,nitroprusside)etc..The use ofdobutamine and milrinone subject to this kind of drug and dose relatedBeckoning tachycardia and other arrhythmia reaction limits,and use of the two drugs to mortality in patients with heart failure increased reports;andlong time use of nitroglycerin(>12h)were easy to produce drug toleranceto the drug;in spite of sodium nitroprusside is a strong vasodilator,but its use requires close monitoring,and its metabolites in cyanide andthiocyanate,have stronger toxicity.The toxicity of the drug factors limit theirpractical application in clinic.Therefore,it is necessary to further research and development of new drug treatment has good curative effect,lowtoxicity of decompensated heart failure.The natriuretic peptide family(atrial natriuretic peptide,brain natriuretic peptide,ANP;BNP;C-type natriuretic peptide,CNP)findings offer new hope for the treatment of heart failure.Especially at present the research of BNP is more,it has been confirmed that BNP can directly relax vascular smooth muscle and antagonism of angiotensin ? and vasodilation,inhibition of the renin and aldosterone secretion,increased glomerular filtration rateand inhibition of renal medullary collecting duct sodium reabsorption of sodium and advantageous,diuretic effect,can improve vascular remodelingthrough inhibition of smooth muscle cells proliferation.Veins of patients withheart failure with BNP can reduce the pulmonary capillary wedge pressure(PCWP),right atrial pressure(RAP),peripheral vascular resistance(SVR)and reduce the sodium and water retention,rapidly improve hemodynamic abnormality.So far,BNP is mainly used for acute decompensated heart failure(ADHF)treatment,and achieved good therapeutic effect. |
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