OBJECTIVE:To observe therapeutic efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute decompensated heart failure (ADHF). METHODS:129 ADHF patients admitted in our hospital during Jul. 2013-Jul. 2015 were randomly divided into observation group(69 cases)and control group(60 cases). Control group was giv-en routine treatment. Observation group was additionally given rhBNP 1.5 μg/(kg·d)vein shock(d1),and then rhBNP 1 mg+5%Glucose injection 100 ml by 0.007 5 μg/(kg·min),ivgtt(d2-4). Treatment courses of 2 groups lasted for 7 d. Therapeutic efficacy and heart function indexes [left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDd)] were observed in 2 groups as well as NT-proBNP level,medication fluid intake and urine volume 24 h after medication. The occurrence of ADR was observed. RESULTS:3 cases dropped out and 66 cases were included finally in doservation group. Total effective rate of AD-HF therapy in observation group (96.97%) was significantly higher than in control group (86.67%),with statistical significance (P<0.05). There was no statistical significance in LVEF,LVDd and NT-proBNP between 2 groups before treatment(P>0.05). Af-ter treatment,LVEF of 2 groups were increased significantly while LVDd were decreased significantly;LVEF of observation group [(42.3±3.6)%] was significantly higher than in control group[(37.9±3.3)%],while LVDd of observation group [(55.5± 3.6)%] was significantly lower than in control group[(61.3 ± 3.4)%]. NT-proBNP levels of 2 groups were decreased significant-ly,and the observation group [(1 389.5±29.6)pg/ml] was significantly lower than the control group [(2 778.0±26.8)pg/ml]. 24 h after medication,urine volume of 2 groups were significantly higher than medication fluid intake,and urine volume of observation group [(1 781.4 ± 89.7)ml] was significantly higher than that of control group [(1 372.6 ± 78.3)ml],with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (3.03%) and control group (5.00%),without statistical significance(P>0.05). CONCLUSIONS:rhBNP is significantly effective for ADHF,promotes heart function recovery and reduces renal function injury with good safety.%目的：观察冻干重组人脑利钠肽（rhBNP）治疗急性失代偿性心力衰竭（ADHF）的疗效和安全性。方法：选取2013年7月－2015年7月我院收治的ADHF患者129例，按照随机数字数字表法分为观察组（69例）和对照组（60例）。对照组患者给予常规治疗，观察组患者在对照组基础上给予注射用rhBNP 1.5μg/（kg·d）静脉冲击（d1），之后给予注射用rhBNP 1 mg+5％葡萄糖注射液100 ml以0.0075μg/（kg·min）的速度ivgtt（d2～4）。两组患者疗程均为7 d。观察两组患者临床疗效、心功能指标[左室射血分数（LVEF）、左室舒张末期内径（LVDd）]、给药24 h后生物标志物N-末端脑钠肽原（NT-proBNP）水平、液体摄入量和尿量，并观察不良反应发生情况。结果：观察组脱落3例，最终入组66例。观察组患者ADHF治疗总有效率（96.97％）明显高于对照组（86.67％），差异有统计学意义（P＜0.05）。治疗前，两组患者LVEF、LVDd和NT-proBNP水平比较，差异无统计学意义（P＞0.05）。治疗后，两组患者LVEF水平明显升高，LVDd水平明显降低，且观察组患者LVEF水平[（42.3±3.6）％]明显高于对照组[（37.9±3.3）％]，观察组患者LVDd[（55.5±3.6）％]明显低于对照组[（61.3±3.4）％]；两组患者NT-proBNP水平明显降低，且观察组患者[（1389.5±29.6）pg/ml]明显低于对照组[（2778.0±26.8）pg/ml]；用药24 h后，两组患者的尿量均明显高于液体摄入量，且观察组患者的尿量[（1781.4±89.7）ml]明显高于对照组[（1372.6±78.3）ml]，差异均有统计学意义（P＜0.05）。观察组患者（3.03％）与对照组（5.00％）的不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：rhBNP治疗ADHF具有较好的临床疗效，可促进患者心功能恢复，减少肾脏功能损害的发生，安全性较高。
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