伊伐布雷定对慢性心力衰竭患者血浆桥接整合因子1含量的影响

Effect of Ivabradine on the Plasma Bridging Integrator 1 Level of Patients with Chronic Heart Failure

目的:探讨伊伐布雷定对慢性心力衰竭(chronic heart failure,CHF)患者血浆中桥接整合因子1(bridging integrator 1,Bin1)的影响。方法:收集左室射血分数(left ventricular ejection fraction,LVEF)小于40%的CHF患者40例,分为伊伐布雷定组20例,常规治疗组20例;选择23例同期体检且年龄、性别与实验组无统计学差异者作为对照组。入选对象采集清晨空腹静脉血,CHF患者于治疗30天后再次采集空腹静脉血。测定血浆Bin1和NT-proBNP浓度,心脏彩超检测LVEF、左室舒张末期内径(end-diastolic diameter of left ventricle,LVEDd)、E峰、A峰及E/A比值。结果:CHF患者血浆Bin1浓度(1047.85±304.82 pg/mL)较对照组(1248.84±238.04 pg/mL)显著降低,差异有统计学意义(P<0.05)。CHF患者血浆Bin1浓度与LVEF呈正相关(r=0.567,P<0.05),与LVEDd (r=-0.332,P<0.05)、NT-proBNP呈负相关(r=-0.509,P<0.05)。伊伐布雷定组治疗后Bin1浓度较治疗前升高(△234.98±267.18 pg/mL),常规治疗组治疗后Bin1浓度较治疗前升高(△34.87±66.89 pg/m L),伊伐布雷定组治疗前后血浆Bin1浓度变化常规治疗组更明显,差异具有统计学意义(P<0.05)。结论:CHF患者血中Bin1浓度显著降低,与心功不全程度相关;伊伐布雷定可升高CHF患者血浆Bin1浓度,可能对改善衰竭心肌兴奋收缩耦联、提高心肌收缩力有益。

Objective: To discuss the effect of ivabradine on the plasma level of bridging integrator 1(Bin1) in patients with chronic heart failure(CHF). Methods: 40 cases of CHF patients with left ventricular ejection fraction(LVEF) 40% and 23 healthy people were enrolled in this study. CHF patients were divided into the ivabradine group(n=20) and conventional therapy group(n=20). The concentration of Bin1 and N-terminal pro-brain natriuretic peptide(NT-pro BNP), the changes of cardiac function related parameters were measured and compared between different groups. After 30 days of treatment, all the above-mentioned index were measured in the ivabradine group and conventional therapy group again. Results: Compared with the healthy control group, the concentration of plasma Bin1 was significantly decreased in the CHF group(1248.84±238.04 pg/m L vs. 1047.85±304.82 pg/m L, P<0.05). The concentration of plasma Bin1 in the CHF group was positively correlated with the LVEF(r=0.567, P<0.05), and negatively correlated with the LVEDd(r =-0.332, P<0.05) and NT-pro BNP(r=-0.509, P<0.05). After treatment with ivbradine, the concentration of Bin1 was increased by(△234.98±267.18 pg/m L). While after conventional therapy, the concentration of Bin1 was only increased by(△34.87±66.89 pg/mL).There was significant difference in the changes of Bin1 concentrations between the ivbradine and conventional therapy groups(P<0.05).Conclusions: The level of Bin1 in CHF patients was significantly decreased and was positively correlated with cardiac function. Ivabradine could increase the plasma level of Bin1 in patients with CHF, it is beneficial to improve the cardiac excitation-contraction coupling and increase the myocardial contraction.