The Lyophilized Reconbinant Human Brain Natriuretic Peptide Treatment Acute Decompensated Heart Failure 11 Example Clinical Report

Objective:To explore the efficacy of lyophilized recombinant human brain natriuretic peptide(rhBNP) on acute decompensated heart failure(ADHF),and its side effects on hypotension and renal function.Methods:After isotropic agents,diuretics,vasodilators were prescribed respectively,11 cases of patients with ADHF whose clinical symptoms and signs had no obvious improvement and were added with lyophilizedand rhBNP.At first 1.5～2μg/kg of lyophilized rhBNP was iv, then 0.0075～0.01μg/kg/min ivdrop continued 24h～72h.To take all observation indexs of pre-administration of lyophilized rhBNP as the research object,the former as the control.To observe clinical symptoms and signs,blood pressure,heart rate,respritory rate,the change of heart function class,within 24h after pharmacologic treatments,and the plasma concentration of K~+,Na~+ and creatinine(Cr) level changes,Within 72h after pharmacologic treatments.Results:11 cases of patients with ADHF,after treatment of lyophilized rhBNP 24 h(18±6h),and compared to before treatment,life indicators and clinical symptoms and signs improved markedly.8 cases decreased systolic and diastolic blood pressure,heart rate and seven cases of respiratory rate slowed,in the 10 cases of respiratory difficulties of varying degrees in both improved volume increased significantly.In the course of treatment had no serious hypotension and renal dysfunction adverse reactions.1.After treatment of lyophilized rhBNP,the ADHF patients appeared lower systolic pressure(SBP) and diastolic pressure(DBP),P＜0.01;lower heart rate(HR) and respiratory rate (R),P＜0.05;the degree of dyspnea improved,P＜0.01;the amount of urine increased obviously, P＜0.01.2.After treatment of lyophilized rhBNP,the clinical symptoms and the symptom (palpitation,short of breath,lung rales,edema)were relieved significantly.1 case of patient improved four teams,3 cases of patients improved five items,2 cases of patients improved two items,1 case had any other improvement.3.To take New York heart association(NYHA) class as the standard,After treatment of lyophilized rhBNP,there were 7 cases of patients whose heart function improvedⅡgrades.4 cases of patients improvedⅠgrade.4.Within 72h after pharmacologic treatments the plasma concentration of Na~+ declined obviously and the plasma concentration of K~+ increased,there was obvious difference between two groups(P＜0.05).Between studying period,all of the patient had the chemotherapy history of the supplement ation of kalium.5.Within 72h after pharmacologic treatments the plasma concentration of Cr increased slightly,but there was not a statistics difference,P＞0.05.Conclusion:1.After isotropic agents,diuretics,vasodilators were prescribed respectively,11 cases of patients with ADHF had bad clinical therapeutic effects,then were added with lyophilizedand rhBNP,whose clinical symptoms and signs had improved obviously.The blood pressure decreased,heart rate slowed,the plasma concentration of Na~+ declined,the amount of urine increased,heart function improved obviously.2.11 cases of patients with ADHF had not side effects on hypotension and renal function,during therapy of lyophilized rhBNP.