重组人脑利钠肽对冠心病DHF患者心力衰竭症状及血管活性物质的影响研究

摘要

目的 研究重组人脑利钠肽对冠心病失常性心力衰竭(DHF)患者心力衰竭症状及血管活性物质的影响.方法 以冠心病DHF为关键字,rhBNP为相关词,对CNKI数据库进行近3年资料的全面检索,将人选的21份资料纳入观察,进行临床随机对照试验,对方法、结果、结论等方面进行评价,用SPSS 18.0进行Meta分析.结果 rhBNP降低平均收缩压4.66mmHg,95％ CI(-4.33～-2.99,P＜0.005);呼吸困难改善有效差-15.5％,95％ CI(-14.25～ -2.24,P＜0.01);心脏指数增加平均0.10L/(min·m),95％ CI(0.03 ～0.16,P<0.05);脑利钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、内皮素-1(ET-1)等血管活性指标均有不同程度的改善.且均具有统计学意义.结论 使用rhBNP能有效的改善冠心病失常性心力衰竭患者心力衰竭症状及血流动力,敏感性较强,且较为稳定,安全性好,值得广泛推广于临床.%Objective To study the impact of recombinant human brain natriuretic peptide(rhBNP) on decompensated heart failure ( DHF) and vasoactive substance. Methods We took DHF as the key word and rhBNP as the related word for the whole retrieval of literature from CNKI database in recent 3 years, and studied the selected 21 pieces of data. Then we took the randomized clinical trials to e-valuate the methods, results and conclusion, as well as the meta analysis by SPSS 18. 0. Results rhBNP decreased the average diastolic pressure of 4. 66mmHg, with 95% CI ( - 4. 33~ - 2. 99, P < 0. 005 ). The significant difference in the dyspnea improvement was -15.5% , with 95% Cl ( -14.25~-2.24, P<0.01). The average increase of cardiac index was 0. 10L/(min· m), with 95% CI (0. 03 - 0.16, P < 0.05 ). There were improvements on vasoactive indexes of brain natriuretic peptide ( BNP), angiotensin II ( Ang II ) and endothelin - 1 (ET - 1) , with the statistical significance. Conclusion The application of rhBNP can effectively improve the symptoms of heart failure and the hemodynamics for patients with decompensated heart failure. It is relatively sensitive, stable and safe, which is worthy to be popularized clinically.