奈西立肽治疗小儿心力衰竭的安全性和有效性。
文章的细节
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引用
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Jefferies JL, Price JF, Denfield SW, Chang AC, Dreyer WJ, McMahon CJ, Grenier MA, Clunie SK, Thomas A, Moffett BS, Wann TS, Smith EO, Towbin JA
奈西立肽治疗小儿心力衰竭的安全性和有效性。
J Card Fail. 2007 Sep;13(7):541-8。
- PubMed ID
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17826644 (PubMed视图]
- 摘要
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背景:我们假设重组b型利钠肽(BNP)(奈西利肽)可以在不恶化肾功能的情况下改善小儿患者的尿量和心衰神经激素标志物。方法和结果:我们分析了我们的经验,涉及63名连续儿童的140次奈西利肽输注。治疗前后测定血清BNP和电解质水平。开始给药时剂量为0.01 mcg.kg.min,不需要丸剂,滴定至最大0.03 mcg.kg。最小,0.005微克千克。最小增量。监测血压、心率和心律。在一项亚研究中,20例失代偿性心肌病相关心力衰竭患者接受了72小时的奈西利肽治疗,并在治疗前后前瞻性评估醛固酮、去甲肾上腺素、血浆肾素和内皮素-1水平。心率显著降低(P = .001)。排尿量在第1天和第3天显著增加(P <或= .001和.004)。平均血清肌酐水平从1.135 mg/dL下降至1.007 mg/dL (P <或= .001)。在亚研究中,醛固酮水平从37.5 +/- 57.1下降到20.5 +/- 41.9 ng/dL (P = .005)。 Plasma renin, norepinephrine, and endothelin-1 levels decreased nonsignificantly. Two infusions were discontinued because of hypotension. CONCLUSIONS: Nesiritide safely treated decompensated heart failure in children. Increased urine output reflected improving renal function. Improved neurohormonal markers were seen after 72 hours of therapy, and complications were uncommon.
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