rhBNP在心力衰竭合并肾功能不全中的应用前景

被引:7
作者
孙丽秀
高宇囡
支继新
许圆圆
李学奇
机构
[1] 哈尔滨医科大学附属第四医院
关键词
心力衰竭; 重组人脑利钠肽; 心肾综合征;
D O I
10.13241/j.cnki.pmb.2015.06.048
中图分类号
R541.61 [];
学科分类号
1002 ; 100201 ;
摘要
心力衰竭同时合并肾功能不全或肾功能恶化,也称为心肾综合征,是临床心血管疾病的终末阶段,患者的死亡率及再住院率较高。重组人脑利钠肽是利用重组DNA技术制成的人脑利钠肽,与内源性脑利钠肽具有相同的药理作用:扩张血管,降低右房压力及肺毛细血管楔压,减轻心脏负荷,可以选择性扩张冠状动脉,增加冠状动脉的血流量;通过激活心肌细胞内c GMP依赖的蛋白激酶PKG-1,产生细胞应激性保护,降低心肌耗氧量;抑制RAAS及SNS,抑制反射性心动过速和血管收缩,无正性肌力作用和正性心率作用,抑制心脏重塑。重组人脑利钠肽作用于肾脏可以改善肾脏血流灌注,提高肾小球滤过率。虽然重组人脑利钠肽治疗心力衰竭取得了很好地效果,但其对心力衰竭患者肾功能的影响仍存在争议。重组人脑利钠肽具有多重活性且不良反应少,已被许多专家视为很有应用前景的新药。
引用
收藏
页码:1189 / 1191
页数:3
相关论文
共 13 条
[1]   奈西立肽对高龄急性失代偿性心力衰竭患者心、肾相关指标的影响附视频 [J].
付士辉 ;
伊双艳 ;
朱兵 ;
刘源 ;
王亮 ;
叶平 ;
骆雷鸣 .
中国循证心血管医学杂志, 2011, (05) :347-350
[2]   重组人脑利钠肽对中国人群急性心力衰竭影响的Meta分析 [J].
陆明 ;
黄好华 ;
罗建春 ;
赵子粼 .
中国循证医学杂志, 2010, 10 (05) :570-577
[3]   Combination of Loop Diuretics With Thiazide-Type Diuretics in Heart Failure [J].
Jentzer, Jacob C. ;
DeWald, Tracy A. ;
Hernandez, Adrian F. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2010, 56 (19) :1527-1534
[4]  
Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action[J] . Uri Elkayam,Tien M.H. Ng,Parta Hatamizadeh,Munir Janmohamed,Anilkumar Mehra.Circulation . 2008 (2)
[5]  
Effects of Perioperative Nesiritide in Patients With Left Ventricular Dysfunction Undergoing Cardiac Surgery[J] . Robert M. Mentzer,Mehmet C. Oz,Robert N. Sladen,Allen H. Graeve,Robert F. Hebeler,John M. Luber,Nicholas G. Smedira.Journal of the American College of Cardiology . 2007 (6)
[6]   Potential applications of outpatient Nesiritide infusions in patients with advanced heart failure and concomitant renal insufficiency (from the follow-up serial infusions of nesiritide [FUSION I] trial) [J].
Yancy, Clyde W. ;
Singh, Ajay .
AMERICAN JOURNAL OF CARDIOLOGY, 2006, 98 (02) :226-229
[7]  
Current Treatments and Novel Pharmacologic Treatments for Hyponatremia in Congestive Heart Failure[J] . Steven R. Goldsmith.The American Journal of Cardiology . 2005 (9)
[8]   Molecular regulation of the brain natriuretic peptide gene [J].
LaPointe, MC .
PEPTIDES, 2005, 26 (06) :944-956
[9]   Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure [J].
Sackner-Bernstein, JD ;
Skopicki, HA ;
Aaronson, KD .
CIRCULATION, 2005, 111 (12) :1487-1491
[10]   Nesiritide does not improve renal function in patients with chronic heart failure and worsening serum creatinine [J].
Wang, DJ ;
Dowling, TC ;
Meadows, D ;
Ayala, T ;
Marshall, J ;
Minshall, S ;
Greenberg, N ;
Thattassery, E ;
Fisher, ML ;
Rao, K ;
Gottlieb, SS .
CIRCULATION, 2004, 110 (12) :1620-1625