Effect of recombinant human brain natriuretic peptide on sepsis induced myocardial dysfunction / 临床麻醉学杂志

ABSTRACT

Objective To explore the interventional effect of recombinant human brain natri-uretic peptide(rhBNP)on the patients with sepsis induced myocardial dysfunction by comparing N-terminal pro-B-type natriuretic peptide(Nt-proBNP),troponin and left ventricular ejection fraction (LVEF).Methods Forty septic patients were admitted into department of critical care medicine from February 2013 to May 201 5.They were randomly divided into control group and rhBNP group,with 20 patients in each group.Both groups received early goal directed therapy(EGDT),and rhBNP group re-ceived additional therapy of rhBNP 1.5 μg/kg bolus,and then 0.075 μg·kg-1 ·min-1 for 48 h.Con-trol group received saline in the same way.Vasoactive agents were used to maintain blood pressure. Concentration of plasma Nt-proBNP and troponin were determined at baseline,on days 1,3,and 7 day by point of care (POCT ).LVEF was also detected by transthoracic echocardiography. Results Concentrations of plasma Nt-proBNP and troponin in rhBNP group were lower than control group on days 1 and 3 (P <0.05).On day 3,levels of Nt-proBNP and troponin in both groups were higher than the days 1 and 7 (P <0.01).LVEF in the rhBNP group was higer than control group on days 3 and 7 (P <0.05 or P <0.01);On day 3,LVEF in both groups was significantly lower than the pre-therapy and day 7 (P < 0.05 or P < 0.01 ).Conclusion rhBNP can improve sepsis induced myocardial dysfunction by decreasing the Nt-proBNP and troponin levels with increased left ventricular ejection fraction.