Objective To investigate the clinical effect of heart failure recombinant human brain natriuretic peptide (rhBNP) in treatment of chronic pulmonary heart disease (CPHD).Methods Fifty-six CPHD patients with heart failure were randomly divided into control and research group who were hospitalized from January 2010 to December 2011.Patient in two groups were given oxygen,anti-infection,nutritional support and complications treatment.In addition patients in the treatment group was treated with rhBNP.Clinical symptoms,signs and cardiac,pulmonary function of two groups were recorded.Results The pulmonary artery pressure in treatment group were (39.7 ± 6.2) mm Hg and (26.5 ± 3.8) mm Hg before and after treatment,and the difference was significant(t =14.992,P =0.000).The pulmonary artery pressure in control group were (38.4 ±5.1) mm Hg and (31.5 ±4.5) mm Hg before and after treatment,and significant difference were seen (9.378,P =0.000).In addition,pulmonary artery pressure were different between in treatment and control group(t =-9.742,P =0.000).The level of BNP in treatment group was (873.0 ± 12.9) ng/L and (382.0 ± 11.4) ng/L,there was significant difference(t =353.627,P =0.000) ;While in control group,the level of BNP was (862.0 ± 12.3) ng/L and (568.0 ± 12.6) ng/L before and after treatment,and the difference was significant(t =156.135,P =0.000).And there was sinificant difference between the two groups after treatment (t =-103.490,P =0.000).The left ventricular ejection fraction before and after treatment in treatment group was (38 ±9)％ and (65 ±8)％,and the difference was significant(t =-23.056,P =0.000) ;While in control group,the Left ventricular ejection fraction was (32 ± 7) ％ and (47 ± 5) ％ before and after treatment,and the difference was significant (t =-16.485,P =0.000).And the difference between two groups was significant(t =18.308,P ＜ 0.01).24 h urine volume in treatment group was (0.9 ± 0.4) L and (1.6 ± 0.3) L before and after treatment,and the difference was significant(t =-17.320,P =0.000) ;While in control group,24 h urine volume was(0.9 ± 0.2) L and (1.0 ± 0.6) L before and after treatment,and the difference was significant (t =-5.250,P =0.000).And the difference between two groups was significant (t =6.592,P =0.000).The total effective rate in treatment was 82.2％ (23/28),higher than that in the control group (57.1％ (16/28),and the difference was significant(x2 =4.139,P ＜ 0.05).Conclusion rhBNP can improve heart function of CPHD patients with heart failure.

Objective To explore the effectiveness and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treatment of C and D level of COPD in stable period .Methods According to the digital table,255 cases of C and D level in patients with stable COPD were randomly divided into the study group and control group,the patients in study group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day,and give tulobuterol patch(2mg/paste),one time every day.The control group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day.The changes of lung function were observed before and after treatment,the clinical symptom score and inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation condition.Results The patients in the two groups after treatment ,pulmonary function ,clinical symptoms score,inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation compared with statistical significance(all P<0.05).Subgroup analysis in study group ,emphysema phenotype visible persistent effect ,chronic bronchitis phenotype ,ACOS phenotype early effective treatment ,decreased efficacy after half a year .The adverse reac-tion of two groups of drugs were respectively 19.7%and 21.0%,there was no significant difference in the incidence of adverse reaction between the two groups (χ2 =0.071,P>0.05).Conclusion Tiotropium bromide inhalation agent with tulobuterol patch can improve clinical symptoms and pulmonary function in patients with C and D level part of the stable phase of COPD .