重组人脑利钠肽对舒张性心力衰竭患者B型脑利钠肽及C反应蛋白的影响

Efficacy of Recombinant Human B- type Natriuretic Peptide on B- Type Natriuretic Peptide and C- Reactive Protein of Diastolic Heart Failure Patients

目的探讨重组人脑利钠肽(rh BNP)治疗舒张性心力衰竭(DHF)的临床疗效及对B型脑利钠肽(BNP)、C反应蛋白(CRP)水平的影响。方法选取医院收治的DHF患者190例,据就诊日期随机分为观察组98例和对照组92例,均给予常规抗心力衰竭治疗,观察组患者加用rh BNP,7 d后行超声心动图检查,并采血检测BNP和CRP水平,判定临床疗效。结果治疗1周后,观察组超声心动图检查等容舒张时间(IVRT)为(83.5±9.7)ms,E峰减速时间(DT)为(125.7±14.2)ms,显著低于对照组的(90.4±10.2)ms和(154.6±15.5)ms(P<0.05),而舒张早期心室充盈血流峰值/舒张晚期血流峰值(E/A)为1.37±0.24,显著高于对照组的1.10±0.21(P<0.05);观察组治疗后的BNP为(89.2±21.1)pg/m L,CRP为(4.8±1.6)mg/L,明显低于对照组的(107.2±24.6)pg/m L和(7.3±2.3)mg/L(P<0.05);观察组治疗后的心率(HR)为(74.8±13.6)次/分,收缩压(SBP)为(109.5±18.3)mm Hg,明显低于对照组的(80.4±12.0)次/分和(113.3±15.7)mm Hg(P<0.05);6 min步行距离为(327.4±58.4)m,显著高于对照组的(295.3±60.1)m(u=3.730,P<0.01);两组患者低血压、转氨酶升高等不良反应率比较,差异无统计学意义(χ2=0.009,P=0.923);观察组治疗总有效率为92.86%,显著高于对照组的83.70%(χ2=3.890,P=0.049)。结论 rh BNP治疗DHF能有效降低神经内分泌激素和炎性水平,改善心室舒张功能,提高运动耐量,疗效显著,且安全可靠。

Objective To observe and explore the efficacy of rhBNP in treatment of DHF and its effects on BNP and CRP. Methods 190 admitted DHF patients were selected and randomized into observation group ( 98 cases ) and control group ( 92 cases ) according to clini-cal visit odds number. The control group was given conventional anti heart failure treatment, based on this the observation group was added with rhBNP. 7 d later, patients were reconducted with ultrasonic beckoning graph examination and blood testing, meanwhile clinical efficacy of 2 groups were determined. Results After 1 week's treatment, sovolumic relaxation time ( IVRT ) ( 83. 5 ± 9. 7 ) ms, E peak decel-eration time ( DT ) ( 125. 7 ± 14. 2 ) ms of the observation group were significantly lower than ( 90. 4 ± 10. 2 ) ms, ( 154. 6 ± 15. 5 ) ms of the control group, and early diastolic ventricular filling flow peak to late diastolic peak flow ( E/A ) 1. 37 ± 0. 24 was significantly higher than the control group's 1. 10 ± 0. 21 ( P < 0. 05 ) . The BNP ( 89. 2 ± 21. 1 ) pg/mL, CRP ( 4. 8 ± 1. 6 ) mg/L of the observation group after treat-ment were significantly lower than control group's ( 107. 2 ± 24. 6 ) pg/mL, ( 7. 3 ± 2. 3 ) mg/L ( P < 0. 05 ) . The HR ( 74. 8 ± 13. 6 ) times/min, SBP ( 109. 5 ± 18. 3 ) mmHg of the observation group were significantly lower than control group ' s ( 80. 4 ± 12. 0 ) times /min , (113.3±15.7)mmHg(P < 0.05),6 min walking quantity(327.4±58.4)m was significantly longer than the control group's(295.3±60.1)m ( u=3. 730, P < 0. 001 );the 2 groups' adverse reaction ratio, such aslow blood pressure, serum transaminase rising had no statistical difference (χ2 =0. 009, P=0. 923 ) . The overall efficiency ratio of observation group ( 92. 86% ) was significantly higher than control group's ( 83. 70% ) (χ2=3. 890, P=0. 049 ) . Conclusion rhBNP treatment of DHF can effectively reduce the neuroendocrine hormones and inflammatory level, improve left ventricular diastolic function, improve exercise tolerance, and further improve clinical efficacy, with clinical safety.