重组人脑利钠肽对急性冠脉综合征患者内皮功能相关因子的影响

The effect of rhBNP on endothelial function related factors of patients with acute coronary syndrome

目的探讨应用rhBNP治疗对ACS患者血管内皮功能的影响,进一步明确rhBNP治疗ACS患者的机制,为其临床治疗ACS患者提供科学的理论依据。方法 ACS患者44例,随机分为试验组30例及对照组14例。对照组采用常规治疗,试验组在常规治疗的基础上加用rhBNP治疗3-5天,两组分别在治疗前及治疗后1周采静脉血,所有标本于收集后统一检测。采用酶联免疫(ELISA)方法测定各组患者用药前及用药后血清中一氧化氮(NO)及内皮素-1(ET-1)的含量,进行统计分析。结果 (1)两组心功能不同分级的患者药物治疗前血清中NO、ET-1含量比较无显著统计学差异(P>0.05);(2)试验组患者药物治疗前后血清中NO及ET-1的含量差值较对照组患者药物治疗前后血清中NO及ET-1的含量差值变化明显(P<0.05),试验组疗效好于对照组。结论 rhBNP能够通过增加血液中NO的含量,降低ET-1的水平,改善ACS患者的血管内皮功能,进而改善冠状动脉的血液供给,是其治疗ACS患者机制之一。为其进一步治疗ACS患者提供理论依据。

Objective Purposes To evaluate rhBNP therapy on endothelial function in patients with ACS, for further identify the mechanism of rhBNP in the treatment of ACS, so as to provide scientific theory for the clinical treatment of patients with ACS. Methotis 44 patients with ACS, and randomly divided into experimental group of 30 patients and control group in 14 cases. 14 eases of control group with conventional therapy, 30 cases of test group was treated on the basis of conventional therapy plus rhBNP treatment for 3- 5 days,the two groups before treatment and one week after treatment, to cull venous blood, and centrifugalize the serum,with cryopreservation deposit. After the collection of all the specimens, giving unified detection. Using enzyme-linked immunosorbent （ELISA） method to detect the content of nitric oxide （NO） and endothelin - 1 （ ET-1 ） levels in serum of each group before and after the treatment. Results （ 1 ） Two groups of patients with different cardiac classification before treatment in patients, the content of Ni- tric oxide and ET-1 levels in serum without significant changes （P 〉 0.05）, no statistical significance. （2） The content difference of the content of Nitric oxide and ET-1 levels in serum before and after treatment in patients is that, the experimental group changed sig- nificantly more than the control group（ P 〈 0.05）,and the curative effect of the experimental group is more effective than the control group. Conclusion Through increasing the content of Nitric oxide in the blood and reducing the ET- 1 levels, rhBNP can improve endothelial function in patients with ACS, thereby improving coronary blood supply, which is one of the mechanisms of its treatment of ACS patients, thus provide a theoretical basis for further treatment of patients with ACS.