重组人脑钠肽对慢性心力衰竭兔的实验研究

The empirical study of rhBNP on the rabbits with chronic heart failure

目的研究重组人脑钠肽(rhBNP)对慢性心力衰竭(CHF)兔血流动力学及心功能的影响。方法用导管捅破兔主动脉瓣,导致超容量负荷型兔的心衰模型。造模成功后动物饲养约5周。心力衰竭兔随机分为三组,分别给予rhBNP、硝普钠和安慰剂(5%葡萄糖)静脉滴注。采用心脏超声图观察用药前后心功能指标。1周后静脉给予同样三种药物,观察用药前后HF兔血流动力学参数的变化。结果HF兔静脉滴注rhBNP后心脏超声检查示LVEF较治疗前明显升高(P<0.05),LVEF从(0.63±0.06)L上升至(0.70±0.07)L(P<0.05);CO无明显变化;LVESV、LAD较治疗前下降明显(P<0.05),LVESV从(2.1±0.7)m l降至(1.2±0.9)m、lLAD由(11.0±1.9)mm下降至(10.1±1.8)mm。而硝普钠治疗组和安慰剂组上述参数无明显变化(P>0.05)。血流动力学监测:给药3 h后三组比较发现:rhBNP组LVEDP、MAP和DBP下降差异具有统计学意义,LVEDP从(19.1±2.8)mm Hg下降至(6.4±5.9)mm Hg(P<0.05);DBP从(72.6±6.3)mm Hg降至(64.6±6.1)mm Hg(P<0.05);硝普钠组SBP、DBP、MAP、LVSP、LVEDP均明显下降(P<0.05),而且以LVSP和SBP下降最为显著;安慰剂组上述参数无明显变化。结论慢性HF兔应用rhBNP后可以增加LVEF,缩小LVESV和LAD。rhBNP能明显降低慢性HF兔的心脏前后负荷,使DBP、MAP明显下降,尤其是LVEDP下降显著。

Objective To study the effects of recombinant human brain natriuretic peptide （rhBNP） on the cardiac hemodynamics and heart function in the rabbits with chronic heart failure. Methods Rabbits with chronic heart failure were induced by damaging aortic valve of rabbits with ductus. Cardiovascular functional indicators were determined using echocardiography after five weeks. Rabbits with heart failure were divided to three groups randomly , and were given rhBNP, nitroprusside sodium and placebo （glucose） to treat. Cardiovascular functional indicators of rabbits were detected with echocardiography before and after therapy. The same three drugs were given after a week, and the change of hemodynamic parameter was observed before and after therapy. Results LVEF of it remarkably increased that rabbits with heart failure that were treated by rhBNP （ LVEF ： 0. 63 ± 0. 06 vs 0. 70 ± 0. 07 ） ; LVESV and diameter of LA was significantly reduced [ LVESV ： （ 2. 1 ±0.7）ml vs（1.2 ±0.9）ml,LAD： （11.0 ± 1.9） mm vs（10. 1 ±1.8）mm] .The change of CO wasn＇t obvious. LVEF,LVESV and LAD weren＇t conspicuous variation in nitroprusside sodium and placebo groups. The detecting of hemodynamic parameter indicated that remarkable changes appeared in the group of rhBNP [ LVEDP： （ 19. 1 ±2. 8）mm Hg vs（6.4 ±5.9）mm Hg;DBP： （72. 6 ±6. 3）mm Hg vs（64. 6 ±6. 1 ）mm Hg（P 〈0. 05） ]. SBP, DBP, MAP, LVSP and LVEDP all decreased in group of nitroprusside sodium, but the variation of LVSP and SBP was more obvious. These parameter weren＇ t change in group of placebo. Conclusion The study and research indicated that rhBNP can increase LVEF and decrease LVESV and diameter of LA ; and it can reduce the pre-load and after-load in these rabbits of heart failure. Diastolic blood pressure and mean arterial pressure significantly reduced;but the decrease of LVEDP is more obvious.