重组人脑利钠肽联合尼可地尔治疗慢性心力衰竭的效果及对心肌能量代谢的影响

Effect of recombinant human brain natriuretic peptide combined with nicorandil in the treatment of chronic heart failure and its influence on myocardial energy metabolism

目的 探讨重组人脑利钠肽联合尼可地尔治疗慢性心力衰竭的效果及对心肌能量代谢的影响。方法将2021年6月至2023年6月收治的100例慢性心力衰竭患者随机分为对照组(尼可地尔治疗)和观察组(重组人脑利钠肽联合尼可地尔治疗),各50例。比较两组的治疗效果。结果 观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的左室射血分数(LVEF)、心排血量(CO)及二尖瓣舒张早期血流速度峰值与晚期血流速度峰值的比值(E/A)高于对照组(P<0.05)。治疗后,观察组的透明质酸(HA)、层粘连蛋白(LN)及Ⅲ型前胶原(PCⅢ)水平低于对照组(P<0.05)。治疗后,观察组的左心室收缩末圆周室壁应力(c ESS)、心肌能量消耗(MEE)及游离脂肪酸(FFA)水平低于对照组(P<0.05)。结论 重组人脑利钠肽联合尼可地尔可提高慢性心力衰竭患者的治疗效果,促进心功能、心肌纤维化情况改善,也能改善心肌能量代谢。

Objective To investigate the effect of recombinant human brain natriuretic peptide combined with nicorandil in the treatment of chronic heart failure and its influence on myocardial energy metabolism.Methods A total of 100 patients with chronic heart failure admitted from June 2021 to June 2023 were randomly divided into control group(nicorandil treatment)and observation group(recombinant human brain natriuretic peptide combined with nicorandil treatment),with 50 cases in each group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF),cardiac output(CO)and the ratio of early to late peak mitral valve diastolic blood flow velocity(E/A)in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of hyaluronic acid(HA),laminin(LN)and procollagenⅢ(PCⅢ)in the observation group were lower than those in the control group(P<0.05).After treatment,the circumferential end-systolic wall stress(cESS),myocardial energy expenditure(MEE)and free fatty acids(FFA)level in the observation group were lower than those in the control group(P<0.05).Conclusion Recombinant human brain natriuretic peptide combined with nicorandil can elevate the therapeutic effect of patients with chronic heart failure,promote the improvement of cardiac function and myocardial fibrosis,and also improve myocardial energy metabolism.