曲前列尼尔对肺动脉高压患者心肺功能及IL-6、HMGB1水平的影响

Effect of Qu Qianlie Nie on cardiopulmonary function and levels of IL-6 and HMGB1 in patients with pulmonary arterial hypertension

目的:探讨曲前列尼尔对肺动脉高压患者心肺功能及白细胞介素6(IL-6)、高迁移率族蛋白B1(HMGB1)水平的影响。方法:选取86例肺动脉高压患者为研究对象,根据治疗方式不同分为对照组和观察组,每组各43例。对照组患者予以波生坦口服治疗;观察组患者在对照组治疗基础上予以曲前列尼尔静脉泵注,疗程均为24周。对比两组患者治疗前后心功能等级变化情况和血浆N末端B型利钠肽原(NT-proBNP)水平、6 min步行距离(6MWD)、肺动脉收缩压(PASP)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、Borg呼吸困难指数(BDI)、血清IL-6和HMGB1水平及不良反应发生情况。结果:治疗后,观察组患者心功能等级优于对照组(P<0.05)。治疗后,两组患者血浆NT-proBNP水平及PASP、BDI均降低(P<0.05),且观察组低于对照组(P<0.05);FVC、FEV1、6MWD均升高(P<0.05),且观察组高于对照组(P<0.05);血清IL-6、HMGB1水平均降低(P<0.05),且观察组低于对照组(P<0.05);两组不良反应发生率无统计学差异(P>0.05)。结论:在波生坦基础上予以曲前列尼尔治疗肺动脉高压患者,可以更好改善心肺功能,抑制IL-6、HMGB1等促炎因子表达,减轻体内炎症反应,且安全性好。

Objective:To explore the effects of Qu Qianlie Nie on cardiovascular function and levels of interleukin-6(IL-6)and high mobility group protein B1(HMGB1)in patients with pulmonary arterial hypertension.Methods:86 patients with pulmonary arterial hypertension were selected and divided into a control group and an observation group according to different treatment methods,with 43 cases in each group.The control group received oral treatment with bosentan,while the observation group received intravenous infusion of traprostanil on the basis of the control group treatment.Both groups were treated for 24 weeks.The changes in cardiac function levels,plasma N-terminal B-type natriuretic peptide(NT-proBNP)levels,6-minute walking distance(6MWD),pulmonary artery systolic pressure(PASP),forced vital capacity(FVC),first second forced expiratory volume(FEV1),Borg dyspnea index(BDI),serum IL-6 and HMGB1 levels,and adverse reactions before and after treatment were compared between the two groups.Results:After treatment,the heart function level of patients in the observation group was better than that in the control group(P<0.05).After treatment,the plasma NT-proBNP levels,PASP,and BDI in both groups of patients decreased(P<0.05),and the observation group was lower than the control group(P<0.05).FVC,FEV1 and 6MWD increased(P<0.05),and the observation group was higher than the control group(P<0.05).The serum levels of IL-6 and HMGB1 in both groups of patients decreased(P<0.05),and the observation group was lower than the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:On the basis of bosentan,the treatment of patients with pulmonary arterial hypertension with Qu Qianlie Nie can improve cardiopulmonary function,inhibit the expression of pro-inflammatory factors such as IL-6 and HMGB1,alleviate inflammation in the body,and have good safety.