前列地尔脂微球载体对老年肺心病并发心力衰竭者血浆BNP、ET-1水平的影响  

Effect of Lipo-PGE1 therapy on plasma concentration of brain natriuretic peptide,endothelin-1 in elderly patients with cor pulmonale complicated with heart failure

作　　者：陆卫东[1] 殷少军[1] 祝炜[1] 李瑾[1] 李微[1] 樊美红[1] 张毅琴[1] 林桦[1] 陈维杰[1] 董福轮[1] 

机构地区：[1]同济大学附属第十人民医院老年科,上海市200072

出　　处：《实用老年医学》2012年第5期391-393,397,共4页Practical Geriatrics

基　　金：上海市干部保健局科研基金资助项目(2011GB24);上海市卫生局科研基金项目(2010082)

摘　　要：目的探讨老年慢性肺心病伴心力衰竭时血浆脑钠素(BNP)、内皮素-1(ET-1)水平变化及前列地尔脂微球载体注射液(Lipo-PGE1,商品名:凯时)对其影响。方法老年慢性肺心病伴心力衰竭患者28例,随机分为治疗组(14例)和常规治疗组(14例)。常规治疗组为降肺动脉压、强心、利尿剂、血管扩张剂等药物并加用鼻导管给氧治疗。治疗组在常规内科治疗同时加用Lipo-PGE1注射液治疗,分别观察治疗10～14d后2组患者临床症状、体征、心率(HR)、呼吸频率(RR)、血压、血氧饱和度(SaO2)、肺动脉压(PAP)和左室射血分数(LVEF)以及血浆BNP、ET-1变化。结果与常规治疗组比较,治疗组治疗10～14d后,患者临床症状与体征改善明显,其SaO2和LVEF显著升高(P<0.05),PAP、HR、RR显著下降(P<0.05)。Lipo-PGE1治疗后血浆BNP、ET-1水平随心衰的纠正而显著降低(P<0.01),与LVEF呈显著负相关(P<0.01),与PAP呈显著正相关(P<0.05)。结论 Lipo-PGE1在改善老年慢性肺心病伴心力衰竭患者心功能和降低PAP的同时,也降低患者血浆BNP、ET-1水平,提示Lipo-PGE1可通过多环节对老年慢性肺心病心力衰竭治疗过程发挥作用。Objective To investigate the curative effects of Lipo-PGE1 therapy on senior patients with cor pulmonale complicated with heart failure and the influence on plasma brain natriuretic peptide（BNP）,endothelin-1（ET-1）.Methods Twenty-eight senior patients with cor pulmonale complicated with heart failure were randomly divided into treatment group and routine group.The routine group（14 cases） received routine therapy,while the treatment group（14 cases） was treated by Lipo-PGE1 combined with routine therapy for 10-14 days.The clinical signs,blood pressure,heart rate,respiratory rate,SaO2）,pulmonary artery pressure（PAP） and left vertricular ejection fraction（LVEF） were observed before and after treatment.The concentrations of plasma BNP,ET-1 were also measured at the beginning and 10-14 days later.Results The clinical symptoms and signs were significantly improved,SaO2and LVEF were significantly elevated（P0.05）,and PAP,RR were significantly reduced（P0.05） in treatment group.The plasma levels of BNP,ET-1 were significantly decreased after treatment in both groups,especially in the treatment group（P0.01）.The plasma levels of BNP,ET-1 had a significantly negative correlation with LVEF（P0.01）,and positive correlation with PAP（P0.01）.Conclusions Lipo-PGE1 therapy not only significantly improves heart function on senior patients with cor pulmonale complicated with heart failure,but also decreases PAP and levels of BNP,ET-1.Lipo-PGE1 plays a more important role by many link mechanisms.

关 键 词：前列地尔脂微球载体 老年人 肺心病 心力衰竭 脑钠素 内皮素-1 

分 类 号：R541.5[医药卫生—心血管疾病] R541.6[医药卫生—内科学]