Rationality of recombinant human brain natriuretic peptide in treatment of acute decompensated heart failure
Objective To investigate the clinical use of recombinant human brain natriuretic peptide(rhBNP)for injection in treatment of acute decompensated heart failure(ADHF)in Zhoushan Hospital and analyze its rationality.Methods The data of patients diagnosed as suffering from ADHF and received treatment with rhBNP from January 2022 to December 2023 in Zhoushan Hospital were collected.The rationality of rhBNP was analyzed and evaluated according to the drug instructions and the latest guidelines,and the efficacy evaluation and adverse drug reaction(ADR)were observed.Results A total of 98 patients aged(61.61±6.75)years old were included in this study.Of the 98 patients,60 were male and 38 female.Meanwhile,42(42.86%)patients received rhBNP alone and 56(57.14%)underwent combined treatment.rhBNP is mainly used for ADHF patients who were rated as grade Ⅱ-Ⅳ by the New York Heart Association Heart Function Classification(NYHA).Among 98 patients,80(81.63%)met the indications in the drug instructions.The usage and dosage of rhBNP injection were basically reasonable.Twenty-eight patients(28.57%)had a medication course of less than 1 d,55(56.12%)1 to 7 d and 15(15.31%)over 7 d.Thirty-six patients(36.73%)had unreasonable drug use.The overall efficacy evaluation after treatment was 90.82%and the incidence of ADR was 12.24%.There was no significant difference between gender and age groups(P>0.05).In the patients with renal impairment,the rate of ADR was significantly increased with the severity of the impairment(P<0.05).When rhBNP was used in combination with diuretics or ACEI/ARB,the overall efficacy and safety were similar to those patients receiving rhBNP alone.However,the overall efficacy was low and the incidence of ADR was remarkably high when rhBNP was used in combination with β blockers(P<0.05).Conclusion The application of rhBNP in Zhoushan Hospital is basically reasonable,but it is still necessary to avoid the problems of excessive indications and long treatment courses.In clinical application,a comprehensive evaluation of the patient's condition should be conducted,and personalized treatment plans should be developed.
Recombinant human brain natriuretic peptideAcute decompensated heart failureRational medicationAdverse drug reaction
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