目的探讨重组人脑利钠肽治疗急性失代偿性心力衰竭(ADHF)的临床效果及安全性。方法选取2012年1月—2014年8月新化县人民医院收治的ADHF患者84例,随机分为对照组40例与观察组44例。对照组患者给予硝酸甘油治疗,观察组患者给予重组人脑利钠肽治疗,两组患者均治疗72h。比较两组患者治疗前后射血分数(EF)和肺动脉压(PAP)、呼吸困难与全身临床症状改善情况、总液体出入量、呋塞米用量、不良事件发生情况。结果治疗前两组患者EF、PAP比较,差异无统计学意义(P>0.05);治疗后观察组EF高于对照组,PAP低于对照组,差异有统计学意义(P<0.05);治疗后观察组EF高于治疗前,PAP低于治疗前,差异有统计学意义(P<0.05);治疗后对照组EF、PAP与治疗前比较,差异无统计学意义(P>0.05)。治疗后观察组患者呼吸困难改善总有效率高于对照组,全身症状改善总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者总液体出入量、不良事件发生率比较,差异无统计学意义(P>0.05)。观察组患者呋塞米用量少于对照组,差异有统计学意义(P<0.05)。结论重组人脑利钠肽治疗ADHF的临床效果确切,能改善患者的血流动力学指标及临床症状,其安全性与硝酸甘油类似。 Objective To investigate the clinical effect and safety of recombinant human brain natriuretic peptide in the treatment of acute decompensated heart failure (ADHF). Methods Eighty-four ADHF patients admitted to Xinhua County People’s Hospital from January 2012 to August 2014 were randomly divided into control group (40 cases) and observation group (44 cases). Patients in the control group were treated with nitroglycerin, and patients in the observation group were treated with recombinant human brain natriuretic peptide. Both groups were treated for 72 hours. The ejection fraction (EF) and pulmonary arterial pressure (PAP), dyspnea and clinical symptoms, total fluid intake and discharge, the amount of furosemide and incidence of adverse events were compared between the two groups before and after treatment. Results There was no significant difference in EF and PAP between the two groups before treatment (P> 0.05). After treatment, the EF in observation group was higher than that in control group and PAP was lower than that in control group (P <0.05) After treatment, EF in the observation group was higher than that before treatment, PAP was lower than before treatment, the difference was statistically significant (P <0.05). There was no significant difference in EF and PAP between the two groups after treatment (P> 0.05). After treatment, the total effective rate of improvement of dyspnea in observation group was higher than that of control group, and the total effective rate of general symptom improvement was higher than that of control group (P <0.05). There was no significant difference between the two groups in the total fluid intake and the incidence of adverse events (P> 0.05). The use of furosemide in the observation group was less than that of the control group, with a significant difference (P <0.05). Conclusion The clinical efficacy of recombinant human brain natriuretic peptide in the treatment of ADHF is definite. It can improve hemodynamics and clinical symptoms of patients, and its safety is similar to that of nitroglycerin.