rhBNP联合琥珀酸美托洛尔对慢性心力衰竭患者心功能及miR-499、miR-208a水平的影响  

Effects of rhBNP combined with metoprolol succinate on cardiac function and levels of miR-499 and miR-208a in patients with chronic heart failure

作　　者：田紫薇 吕雄胜 TIAN Ziwei;LYV Xiongsheng(Department of ECG Room,The Lishui Second Peo-ple's Hospital,Lishui 323000,China)

机构地区：[1]丽水市第二人民医院特检科心电图室,浙江丽水323000 [2]丽水市第二人民医院心血管内科,浙江丽水323000

出　　处：《全科医学临床与教育》2025年第1期22-26,共5页Clinical Education of General Practice

摘　　要：目的观察重组人脑利钠肽(rhBNP)联合琥珀酸美托洛尔对慢性心力衰竭患者心功能及血清微小RNA(miR)-499、miR-208a水平的影响。方法选择120例慢性心力衰竭患者,按照随机数字表法分为rhBNP组和常规组,各60例。常规组给予琥珀酸美托洛尔治疗,rhBNP组给予rhBNP联合琥珀酸美托洛尔治疗。比较两组临床疗效与不良反应,检测两组治疗前后的N-末端脑钠肽前体(NT-proBNP)、miR-499、超敏-C反应蛋白(hs-CRP)、miR-208a、脂质运载蛋白-2(LCN-2)、白介素-6(IL-6)、心功能变化,评估两组6 min步行距离、Lee氏心力衰竭计分差异。结果rhBNP组总有效率为93.33%高于常规组的80.00%,差异有统计学意义(χ^(2)=4.62,P<0.05)。治疗后,rhBNP组miR-499、miR-208a、NT-proBNP、hs-CRP、IL-6、LCN-2水平均低于常规组,差异均有统计学意义(t分别=5.18、6.88、4.43、5.29、8.99、5.75,P均<0.05),LEE评分、左室后壁厚度(LVPW)和左心室舒张末期内经(LVEDD)低于常规组,6 min步行距离和左室射血分数(LVEF)高于常规组,差异均有统计学意义(t分别=4.84、5.83、7.51、-2.10、-5.03,P均<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.00,P>0.05)。结论rhBNP联合琥珀酸美托洛尔治疗慢性心力衰竭可降低miR-499、miR-208a等相关因子水平,改善心功能,减轻心力衰竭症状,提高疗效。Objective To observe the effects of recombinant human brain natriuretic peptide(rhBNP)combined with metoprolol succinate on cardiac function and serum microRNA(miR)-499 and miR-208a levels in patients with chronic heart failure.Methods One hundred and twenty patients with chronic heart failure were selected and divided into the rhBNP group and the conventional group according to the random number table method,60 cases in each.The conventional group was treated with metoprolol succinate,and the rhBNP group was treated with rhBNP combined with metoprolol succinate.The clinical efficacy and adverse effects between the two groups were compared,and the changes of N-terminal brain natriuretic peptide precursor(NT-proBNP),miR-499,hyper-sensitivity-C reactive protein(hs-CRP),miR-208a,lipid-cotransporting protein-2(LCN-2),interleukin-6(IL-6),and cardiac function before and after treatment in the two groups were detected.The differences in six-minute walking distance and Lee's heart failure scoring system between the two groups were evaluated.Results The total effective rate of the rhBNP group was 93.33%,which was higher than that of the conventional group with 80.00%,and the difference was statistically significant(χ^(2)=4.62,P<0.05).After treatment,the levels of miR-499,miR-208a,NT-proBNP,hs-CRP,IL-6 and LCN-2 in rhBNP group were lower than those in conventional group,with statistical significance(t=5.18,6.88,4.43,5.29,8.99,5.75,P<0.05).The Lee score,LVPW,and LVEDD were lower than those of the conventional group,and the 6-minute walking distance and LVFF were higher than those of the conventional group,the differences were statistically significant(t=4.84,5.83,7.51,-2.10,-5.03,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.00,P>0.05).Conclusion rhBNP combined with metoprolol succinate in the treatment of chronic heart failure can reduce the levels of miR-499,miR-208a,and other related factors,improve cardiac function,reduce heart failure symptoms,and imp

关 键 词：重组人脑利钠肽 琥珀酸美托洛尔 慢性心力衰竭 心功能 疗效 

分 类 号：R54[医药卫生—心血管疾病]