目的 探究重組人腦利鈉肽治療老年患者急性心力衰竭的臨床療效和安全性。方法 將2013年1月-12月入住天津市胸科醫(yī)院的88例急性心力衰竭（AHF）患者隨機(jī)分為治療組和對照組，每組44例。兩組患者入院后均常規(guī)進(jìn)行抗心力衰竭藥物治療，對照組在常規(guī)治療基礎(chǔ)上加用硝酸甘油注射液，起始劑量為10 μg/min，勻速靜脈泵入，以5 μg/min的速度遞增直到血壓穩(wěn)定為止。治療組在常規(guī)治療基礎(chǔ)上加用凍干重組人腦利鈉肽，以沖擊量2.0 μg/kg持續(xù)1 h后以0.01 μg/(kg·min)的滴速維持靜脈泵注。兩組患者均持續(xù)治療1周。治療結(jié)束后，觀察兩組的臨床療效，同時比較兩組患者給藥前后收縮壓、舒張壓、心率、Na⁺、K⁺、肌酐（Cr）的變化。結(jié)果 治療后，治療組和對照組的總有效率分別為88.63%、72.73%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組的心率、舒張壓、收縮壓均較治療前有所下降，治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對照組的舒張壓和收縮壓較治療前有所下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組心率、收縮壓均明顯低于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），同時治療組K⁺水平高于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 重組人腦利鈉肽能明顯改善老年急性心力衰竭患者的臨床癥狀，對此類患者有較好的臨床療效和安全性，值得推廣應(yīng)用。

Objective To evaluate the efficacy and safety of Lyophilized Recombinant Human Brain Natriuretic Peptide in the treatment of elderly patients with acute heart failure (AHF). Methods Elderly patients (88 cases) with AHF who came to Tianjin Chest Hospital for the treatment from January to December 2013 were randomly divided into treatment and control groups (n = 44). The patients in the two groups were accepted conventional drug treatment. The patients in the control group on the basis of conventional treatment added Nitroglycerin Injection with starting dosage of 10 μg/min uniform iv pumping, and increased at a speed of 5 μg/min until blood pressure stability. The patients in the treatment group on the basis of conventional treatment added Lyophilized Recombinant Human Brain Natriuretic Peptide with shock amount of 2.0 μg/kg for 1 h, and in 0.01 μg/(kg·min) dripping speed to maintain iv injection pumping. The patients in both the two groups were treated for 1 week. After the treatment, the clinical effects on the patients in the two groups were observed; At the same time, the changes of systolic and diastolic blood pressure, heart rate, Na⁺, K⁺, and creatinine (Cr) of the patients in the two groups before and after the treatment were compared. Results The effective rates of the patients in the treatment and control groups were 88.63% and 72.73% with significant difference (P < 0.05). After the treatment, the heart rate, diastolic and systolic blood pressure of the patients in the treatment group were decreased, and the difference was statistically significant before and after the treatment (P < 0.05). Diastolic and systolic blood pressure of the patients in the control group were decreased, and the difference was statistically significant before and after the treatment (P < 0.05). After the treatment, the heart rate and systolic blood pressure of the patients in the treatment group were lower than those of patients in the control group with significant difference (P < 0.05):, Meanwhile, K⁺ level of the patients in the treatment group was higher than that of the patients in the control group with significant difference (P < 0.05). Conclusion Lyophilized Recombinant Human Brain Natriuretic Peptide could significantly improve the clinical symptoms in elderly patients with AHF and have a better clinical efficacy and safety for such patients, which is worthy of popularization and application.