环磷腺苷葡胺对老年重度收缩性心力衰竭患者心功能及NT—proBNP水平的影响

Effects of meglumine adenosine cyclophosphate on cardiac function and N-terminal pro-brain natri- uretic peptide in the elderly patients with severely systolic heart failure

目的探讨环磷腺苷葡胺对老年重度收缩性心力衰竭患者心功能及血清N末端B型利钠肽原（NT-proBNP）水平的影响。方法将86例老年重度收缩性心力衰竭患者按随机数字表法分为2组，每组43例，对照组仅用常规治疗，治疗组应用环磷腺苷葡胺加常规治疗，疗程10d，两组治疗前后分别行超声心动图检查心功能及采用电化学发光法测定血清NT—proBNP水平。结果两组患者治疗前后左心室射血分数（LVEF）（％）及左室短轴缩短率（FS）（％）值比较差异均有统计学意义（t=6．13—9．66，P〈0．01），治疗组患者治疗后LVEF（％）及FS（％）值均优于对照组，其差异均有统计学意义（t=2．23—2．42，P〈0．05）；两组患者治疗后血清NT—proBNP水平明显下降，与治疗前比较差异均有统计学意义（t=18．70-20．30，P〈0．01），治疗组治疗后血清NT-proBNP水平明显低于对照组（t=2．17，P〈0．05），治疗组治疗后无明显不良反应。结论老年重度收缩性心力衰竭患者血清NT—proBNP水平明显增高，采用环磷腺苷葡胺治疗既能降低其血清NT—proBNP水平，又能提高其左室射血分数，改善心功能显著，无明显不良反应。

Objective To investigate the effects of meglumine adenosine cyclophosphate （MAC） on cardiac function and N-terminal pro-brain natriuretic peptide （NT-proBNP） in the elderly patients with severely systolic heart failure. Methods According to random number table, a total of 86 elderly patients with severely systolic heart failure was randomly divided into treated （ n = 43 ） and control （ n = 43 ） groups. Both groups of patients were treated with the same conventional therapy, but MAC was given in the treated group. The period of treatment was 10 days. Colored Doppler echocardiography was performed to evaluate the left ventricular function before and after treatment. Serum NT-proBNP concentration was measured by electrochemiluminescence immunoassay. Results Statistical differences in left ventricular ejection fraction （LVEF） and left ventricular fraction shortening （FS）were found after 10 days treatment in both groups compared with those before treatment（ t =6. 13 -9. 66, P 〈0. 01 ）. LVEF and FS in the treatment group were more significantly improved than that of control group after treatment （ t = 2. 23 - 2. 42, P 〈 0. 05 ）. Serum NT-proBNP concentration was decreased after treatment in both groups compared to those before treatment（ t = 18.70 -20. 30, P 〈0. 01 ）. NT-pro BNP level in the treatment group was more significantly decreased than that of control group after treatment （ t =2. 17, P 〈0. 05）. The adverse reaction was not found in the treatment group. Conclusions The serum NT-proBNP level was higher in the elderly patients with severely systolic heart failure. MAC decreased NT-proBNP and increased LVEF. It improved significantly cardiac function without resulting in more side effects.