关键词: 重组脑利钠肽, 心肾综合征, 临床疗效

Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the effect of recombinant human brain natriuretic peptide (rhBNP) on patients with cardiorenal syndrome.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective propensity score matched analysis was used to investigated  the effect of rhBNP on patients with cardiorenal syndrome who were admitted to the renal ICU of Jinling Hospital from Nov,2013 to Nov,2018.rhBNP treatment group and control group were divided according to whether rhBNP was intravenous injected during treatment.Effect was assessed 72 hours after admission according to the improvement of abnormal signs.The decrease of NTproBNP during ICU hospitalization ≥30% was defined as effective,and <30% was defined as ineffective.
Ｒｅｓｕｌｔｓ：A total of 259 CRS  patients met the inclusion standard of this study,including 74 patients in  rhBNP treatment group and 185 patients in  control group.Before propensity score matched analysis,it′s different in gender,CRRT,ESRD,kidney size and pulmonary hypertension in the two groups.There was no difference in baseline data between the two groups after propensity score matching,with the improvement rate of 6610% in  rhBNP treatment group and 3051% in control group.The treatment efficacy was 7288% in  rhBNP treatment group and 4745% in control group.In rhBNP treated group,CRS type 1 to 3 were all effective,and the efficacy rate of CRS type 4 and 5 were 7429% and 5926%,respectively.Multivariate logistic regression analysis suggested that SLE was an independent risk factor for failure of rhBNP treatment.Serum creatinine increased more than 2652 μmol/L during rhBNP treatment in 7 patients whose systolic blood pressure decreased by 45(33,62) mmHg.In the control group,there were 9 patients whose serum creatinine increased by more than 2652 μmol/L during treatment.There was no significant difference in renal injury rate between  two groups.
Ｃｏｎｃｌｕｓｉｏｎ：The clinical application of rhBNP in the treatment of CRS can effectively reduce NTproBNP and improve  clinical efficacy.All patients with CRS type1 to 3 are effective,and some patients with CRS type 4 and 5 need other comprehensive treatment in addition to the use of rhBNP.However,the decline of systolic blood pressure during rhBNP treatment should be monitored to avoid renal injury.