文章摘要
张磊 李曦哲 樊永亮 顾红兵 叶一舟.新活素治疗心脏术后心肾综合征50 例疗效观察[J].,2015,15(24):4668-4671
新活素治疗心脏术后心肾综合征50 例疗效观察
Efficacy of rhBNP for the Treatment of Cardiorenal Syndrome after Cardiac Surgery
  
DOI:
中文关键词: 心脏术后  心肾综合征  重组人脑钠肽  心功能  肾功能
英文关键词: Postcardiac surgery  Cardiorenal syndrome  Recombinant human brain natriuretic peptide  Heart function  Renal function
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作者单位
张磊 李曦哲 樊永亮 顾红兵 叶一舟 上海交通大学附属第一人民医院心脏及大血管外科 
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中文摘要:
      目的:观察及评价新活素治疗心外科术后心肾综合征的疗效。方法:50例心外科术后心肾综合征(CRS)患者经多巴胺类、利 尿剂、硝酸酯类、米力农等常规抗心衰药物治疗无效后,加用新活素,微量泵静脉泵入48 h进行疗效观察。结果:加用新活素治疗 24 h后尿量明显增多,肌酐(Scr) 、血尿素氮(BUN)降低,肾小球滤过率(eGFR)增高,中心静脉压(CVP)下降,动脉压(收缩压和舒 张压)升高。48 h后血浆脑钠肽(BNP)水平下降,7 天后复查心脏超声,示左室射血分数(LVEF)升高。结论:心外科术后心肾综合 征患者在常规抗心衰药物治疗无效时,加用小剂量新活素(<0.01 ug/kg/min),可改善心肾综合征患者的心肾功能,具体作用机制可 能是先改善患者肾功能,继而心功能得以改善。
英文摘要:
      Objective:To observe and evaluate the efficacy of recombinant human brain natriuretic peptide (rhBNP) for the treatment of cardiorenal syndrome after cardiac surgery.Methods:Fifty patients with cardiorenal syndrome after cardiac surgery failed to the routine therapy with dopaminergics, diuretics, nitrates and milrinone, and then were given rhBNP intravenous pump for 48 h. The efficacy was observed.Results:After the additional treatment with rhBNP, the urine volume was obviously increased; serum creatinine(Scr) and blood urea nitrogen(BUN) was decreased; estimate glomerular filtration rate(eGFR) was increased; central venous pressure(CVP) reduced; and artery blood pressure(ABP) including both systolic and diastolic blood pressure was increased. After 48 hour, blood brain natriuretic peptide was lowered and the left ventricle ejection fraction(LVEF) was elevated 7 days later.Conclusion:Additional small dose rhBNP (<0.01 滋g/kg/min) can help improve heart and renal function of patients with cardiorenal syndrome after cardiac surgery when routine therapy has no effect, which may improve patients' renal function first, and then heart function gets improved.
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