目的 探究重组人脑利钠肽治疗老年患者急性心力衰竭的临床疗效和安全性。方法 将2013年1月-12月入住天津市胸科医院的88例急性心力衰竭（AHF）患者随机分为治疗组和对照组，每组44例。两组患者入院后均常规进行抗心力衰竭药物治疗，对照组在常规治疗基础上加用硝酸甘油注射液，起始剂量为10 μg/min，匀速静脉泵入，以5 μg/min的速度递增直到血压稳定为止。治疗组在常规治疗基础上加用冻干重组人脑利钠肽，以冲击量2.0 μg/kg持续1 h后以0.01 μg/(kg·min)的滴速维持静脉泵注。两组患者均持续治疗1周。治疗结束后，观察两组的临床疗效，同时比较两组患者给药前后收缩压、舒张压、心率、Na⁺、K⁺、肌酐（Cr）的变化。结果 治疗后，治疗组和对照组的总有效率分别为88.63%、72.73%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组的心率、舒张压、收缩压均较治疗前有所下降，治疗前后差异有统计学意义（P<0.05）。对照组的舒张压和收缩压较治疗前有所下降，差异有统计学意义（P<0.05）。治疗后，治疗组心率、收缩压均明显低于对照组，两组比较差异有统计学意义（P<0.05），同时治疗组K⁺水平高于对照组，两组比较差异有统计学意义（P<0.05）。结论 重组人脑利钠肽能明显改善老年急性心力衰竭患者的临床症状，对此类患者有较好的临床疗效和安全性，值得推广应用。

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.