The effect of rhBNP on chronic heart failure with diuretic resistance
WANG Lin
CHEN Lixue
XIA Xuhui
WAN Shu-ping
Abstract：Objective To investigate the effect of recombinant human brain natriuretic peptide ( rhBNP) in patients with resistance of diuretics and chronic heart failure and its mechanism .Methods Select from August 2014 to April 2015 , 62 cases of chronic heart failure patients with diuretics resistant , depending on admission sequence of ,they were randomly divid -ed into control group ( n =34 ) and observation group ( n =28 ) .Basic treatment and basic treatment plus rhBNP treatment were given respectively , the 2 groups of patients'vital signs ,electrolytes , daily morning body mass and liquid volume were re-corded,observe the improvement of heart function .The left ventricular ejection fraction (LVEF), left ventricular end-systol-ic/diastolic diameter ( LVESD/LVEDD) were measured by cardiac color Doppler .The levels of serum vascular nervous angio-tensin II ( Ang II), aldosterone ( ALD), norepinephrine ( NE), serum N-terminal pro brain natriuretic peptide precursor (NT-proBNP) and antidiuretic hormone( ADH) were determined.The rate of re-entry in 3 months were followed-up .Results After treatment, the total effective rate of observation group was82 .1 % higher than the control group (35.3%,χ2 =13.709, P <0.01).After treatment,compared with before treatment ,2 groups'LVEF,HR significantly improved ( P <0.05),and the observation group's LVEF, HR improved more obviously ( P <0.05).LVEDD and LVESD changes before and after treatment were not significant ( P >0.05), but still showed a decreasing trend .Observation group from begins of treatment , the urine volume increased significantly , and gradually diuretic effect became more obvious , to 4-5 days,the effect reached the steady state , but still maintain a good diuretic effect , while the control group patients with limited diuretic effect .Curative effect in observed group is better than control group ( t 1d=9.853, t2d =8.426, t 3d=10.646, t 4d =10.166, t 5d=8.580, P <0.01).After treatment, observe groups of patients with body mass decreased more markedly , better than the control group, until 4 to 5 days still shows better body quality decline trend ( t 1d =4.897, t 2d =7.837, t 3d =7.030, t 4d=7.800, t5d =6.981, P <0.01).After treatment, 2 groups of blood urea nitrogen, serum creatinine, serum sodium indexes were com-pared with those before treatment showed significantly improvement ( P <0.05), and observation of blood urea nitrogen (BUN), blood creatinine compared with the control group showed better therapeutic effect ( P <0.01).The 2 groups had little change in serum potassium ( P >0.05).Compared with before treatment, after treatment in control group, serum ALD and NT-proBNP significantly decreased ( P <0 .01 ) , and the observation group's nerve endocrine factor 4 was significantly decreased ( P <0.01).Compared with the control group , the observation group significantly decreased of the serum Ang II , NE, and NT proBNP level ( P <0.01).Patients were discharged after a follow-up of 3 months, the control group's re-hospi-talization were 14 cases (41.2%), which were higher than in the observation group of 5 cases (17.9%) (χ2 =3.929, P <0.05).Conclusion Recombinant human brain natriuretic peptide can rapidly improve the symptoms of heart failure , reduce the retention of water and sodium , alleviate diuretic resistance , lower readmission rate and its mechanism may be related to its diuretic collaborative function and neurohormonal antagonism .
Keywords：Recombinant human brain natriuretic peptideHeart failureDiuretic resistanceNeuroendocrine factor
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1211-1214,1218 )