重组人脑利钠肽对严重心力衰竭患者心肌纤维化标志物水平的影响  

Effect of recombinant human brain natriuretic peptide on myocardial fibrosis markers in patients with severe heart failure

作　　者：蒋璐 龚国彪 康小兰 周芳 李燕 周政 Jiang Lu;Gong Guobiao;Kang Xiaolan;Zhou Fang;Li Yan;Zhou Zhen(Department of General Medicine,Dazu District Hospital,Chongqing 402360,China)

机构地区：[1]重庆市大足区人民医院全科医疗科,402360

出　　处：《疑难病杂志》2020年第10期1005-1008,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：重庆市卫生局医学科研项目(2015MSXM182)。

摘　　要：目的观察重组人脑利钠肽对严重心力衰竭患者心肌纤维化标志物水平的影响。方法选择2017年1月—2019年9月重庆市大足区人民医院全科医疗科诊治急性心力衰竭(AHF)患者126例,随机数字表法分为新活素组(n=63)和左西孟旦组(n=63),在常规治疗基础上给予相应治疗。分别在入组时(治疗前)和治疗后第11天(治疗后),通过心脏超声评估心功能,检测血清NT-proBNP及MMP-2等纤维化标志物的变化。结果治疗后,2组患者LVEF水平升高,且新活素组高于左西孟旦组(P<0.05),而LVEDD和血清NT-proBNP水平均下降(P<0.05),新活素组E/A比值升高(t/P=1.997/0.027),但2组比较差异无统计学意义(P>0.05);新活素组MMP-2、TIMP-1、PⅠNP和PⅢNP水平均明显下降(t=5.096、6.377、4.489、4.052,P均<0.01),而左西孟旦组仅MMP-2水平下降(t=3.138,P=0.001)。治疗后新活素组患者MMP-2、TIMP-1和PⅠNP水平明显低于左西孟旦组(t/P=3.020/0.002、3.237/0.001、2.478/0.009)。结论严重AHF患者经过新活素治疗后,心功能显著改善,心肌纤维化标志物水平明显下降。Objective To observe the effect of recombinant human brain natriuretic peptide(rhBNP)on myocardial fibrosis markers in patients with severe heart failure.Methods One hundred and twenty-six patients with acute heart failure(AHF)were selected from the General Medical Department of Dazu people's Hospital from January 2017 to September 2019.The patients were randomly divided into rhBNP groups(n=63)and control group(n=63).On the basis of conventional treatment,corresponding treatment was given.At the time of admission(before treatment)and 11 days after treatment(after treatment),cardiac function was evaluated by echocardiography,serum NT-proBNP and MMP-2 were detected,and their correlation with the two drugs was analyzed.Results After treatment,the level of LVEF in the two groups was increased,and the level of rhBNP group was higher than that of the control group(P<0.05).However,LVEDD and serum NT-proBNP levels decreased on average(P<0.05),and E/A ratio increased in the rhBNP group(t/P=1.997/0.027),but there was no significant difference between the two groups(P>0.05).The levels of MMP-2,TIMP-1,PⅠNP and PⅢNP in rhBNP group were significantly decreased(t=5.096,6.377,4.489,4.052,all P<0.01).In the control group,only MMP-2 level decreased(t=3.138,P=0.001).After treatment,the levels of MMP-2,TIMP-1 and PⅠNP in rhBNP group were significantly lower than those in control group(t/P=3.020/0.002,3.237/0.001,2.478/0.009).Conclusion In severe AHF patients,cardiac function was significantly improved and the levels of myocardial fibrosis markers were significantly decreased after treatment with rhBNP.

关 键 词：重组人脑利钠肽 严重心力衰竭 心肌纤维化标志物 

分 类 号：R541.6[医药卫生—心血管疾病] R542.23[医药卫生—内科学]