静脉注射人脑利钠肽对急性失代偿性心力衰竭心率变异性的作用

摘要

目的 观察分析重组人脑利钠肽(rh-BNP)治疗急性失代偿心力衰竭(ADHF)对心率变异性(HRV)的影响.方法 选择28例ADHF患者,采用1.5～2.0 μg/kg负荷剂量静脉推注rh-BNP,随后按0.007 5～0.015 0 μg·kg-1·min-1维持剂量进行微量泵静脉内注射24 h.治疗前后均行24 h动态心电图监测检查,对rh-BNP治疗前后进行心率功率谱时域和频域分析.结果 rh-BNP治疗后HRV值较对照组显著改善,其中时域指标:全部正常R-R间期的标准差(SDNN)、每5分钟 R-R间期均值的标准差(SDANN)、正常相邻R-R间期差值的均方根(RMSSD)、正常相邻R-R间期差值＞ 50 ms的百分比(PNN50)、心率均显著改善(P＜0.01),频域指标:总频谱(TF)、低频(LF)和高频(HF)亦明显改善(P＜0.01).结论 rh-BNP可改善ADHF患者的HRV.%Objective To investigate the effect of recombinant human brain natriuretic peptide (rh-BNP)on heart rate variability in patients with acute deeompensated heart failure (ADHF). Methods 28 patients with ADHF,based on the routine therapy,were treated with rh-BNP for 24 hours. The heart rate power spectral density and time-domain were analyzed, with 24 hour electrocardiographic monitoring before and after using rh-BNP.Results As compared with that in control group,the time-domain analysis in rh-BNP after the treatment revealed a significant improvement in SDNN, SDANN, RMSSD, PNNS0 ( P ＜ 0.01 ). Heart rate and frequency domain analysis showed there was a obvious improvement of total, low and high frequency components ( P ＜ 0.01 ).Conclusion The rh-BNP can significantly improve the heart rate variability in patients with ADHF.