Effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure

Objective: To discuss the effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure. Methods: A total of 100 elderly patients with chronic heart failure who were treated in the hospital between March 2014 and March 2017 were divided into control group and levosimendan group by random number table, each with 50 cases. Control group received clinical routine therapy for chronic heart failure, and levosimendan group received routine therapy combined with adjuvant levosimendan therapy. The differences in serum levels of RAAS indexes, thyroid hormones, myocardial damage indexes and endothelial function indexes were compared between the two groups before and after treatment. Results: At T0, there was no statistically significant difference in serum levels of RAAS indexes, thyroid hormones, myocardial damage indexes and endothelial function indexes between the two groups. At T1, serum RAAS indexes PRA, AngⅡ and ALD levels of levosimendan group were lower than those of control group;serum thyroid hormones TT3, TT4, FT3 and FT4 levels of levosimendan group were higher than those of control group;serum myocardial damage indexes cTnⅠ, H-FABP and NT-proBNP levels of levosimendan group were lower than those of control group;serum endothelial function index NO level of levosimendan group was higher than that of control group while ET-1 level was lower than that of control group. Conclusion: Adjuvant levosimendan therapy for elderly patients with chronic heart failure can effectively adjust the secretion of neuroendocrine hormones and reduce the myocardial and vascular endothelial damage.

Effect of recombinant human brain natriuretic peptide on serum inflammatory factors, neuroendocrine hormones and cardiac function in patients with acute myocardial infarction complicated with heart failure

Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction complicated with heart failure.Methods:A total of91 cases of acute myocardial infarction with heart failure patients were divided into the control group (n=44) and observation group (n=47) according to the random data table, two groups of patients were given conventional treatment, based on this, the control group was given intravenous infusion of Nitroglycerin Injection treatment, the observation group received intravenous injection of recombinant human brain natriuretic peptide treatment, compared serum inflammatory factors, neuroendocrine hormone and cardiac function and other indexes of two groups before and after treatment.Results: there was no significant difference between the two groups before treatment. After treatment, the levels of TNF-α, hs-CRP, IL-6, MCP-1, LVESD and LVEDD in the two groups were significantly lower than those within the group before treatment, and the observation group was significantly lower than the control group;The two groups after treatment LVEF levels were significantly higher than those in the group before treatment, and the observation group was significantly higher than that of control group;the observation group after treatment PRA, Ang II and ALD and NE levels were significantly lower than those before treatment, and was significantly lower than the control group after treatment, the difference was significant, PRA, Ang, ALD and NE levels of control group before and after the treatment was no significant difference.Conclusion:recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction with heart failure can effectively reduce the serum inflammatory factors and neuroendocrine hormone levels, improve heart function, and have a certain clinical value.

Neuroendocrine hormone amylin in diabetes

The neuroendocrine hormone amylin, also known as islet amyloid polypeptide, is co-localized, co-packaged and cosecreted with insulin from adult pancreatic islet β cells to maintain glucose homeostasis. Specifically, amylin reduces secretion of nutrient-stimulated glucagon, regulates blood pressure with an effect on renin-angiotensin system, and delays gastric emptying. The physiological actions of human amylin attribute to the conformational α-helix monomers whereas the misfolding instable oligomers may be detrimental to the islet β cells and further transform to β-sheet fibrils as amyloid deposits. No direct evidence proves that the amylin fibrils in amyloid deposits cause diabetes. Here we also have performed a systematic review of human amylin gene changes and reported the S20 G mutation is minor in the development of diabetes. In addition to the metabolic effects, human amylin may modulate autoimmunity and innate inflammation through regulatory T cells to impact on both human type 1 and type 2 diabetes.

Adrenocorticotropic hormone-secreting pancreatic neuroendocrine carcinoma with multiple organ infections and widespread thrombosis:A case report

BACKGROUND Ectopic adrenocorticotropic hormone(ACTH)-secreting neuroendocrine tumors are rare diseases.Patients with ACTH-secreting pancreatic neuroendocrine carcinomas have a poor prognosis.Infections and coagulopathies have been reported as the cause of death.However,detailed clinical descriptions of the morbid complications of ACTH-secreting neuroendocrine carcinomas have not been reported.CASE SUMMARY A 78-year-old Japanese woman consulted a medical center due to systemic edema and epigastric discomfort.Laboratory analysis revealed hypercortisolemia with increased ACTH secretion without diurnal variation in serum cortisol level.An enhanced computed tomography(CT)scan revealed a 3-cm tumor in the pancreatic head.The cytological material from endoscopic ultrasound-guided fine-needle aspiration was compatible with ACTHsecreting pancreatic neuroendocrine carcinoma.The Ki-67 index was 40%.She was transferred to Mie University Hospital for surgical treatment.The patient was diagnosed with urinary tract infection,cytomegalovirus hepatitis,esophageal candidiasis,pulmonary infiltrates suspicious for Pneumocystis carinii pneumonia,peripheral deep vein thrombosis,pulmonary embolism,and disseminated intravascular coagulation.The multiple organ infections and thromboses responded well to antimicrobial and anticoagulant therapy.Radioisotope studies disclosed a pancreatic tumor and a metastatic lesion in the liver,whereas somatostatin receptor scintigraphy showed negative findings,suggesting the primary and metastatic tumors were poorly differentiated.A CT scan before admission showed no metastatic liver lesion,suggesting that the pancreatic tumor was rapidly progressing.Instead of surgery,antitumor chemotherapy was indicated.The patient was transferred to another hospital to initiate chemotherapy.However,she died four months later due to the rapidly progressive tumor.CONCLUSION ACTH-secreting pancreatic neuroendocrine neoplasm is a rare disease with a very poor prognosis.The clinical course and acute complications of the tumor remain unreported.Here we report the clinical course of a rapidly progressive case of ACTH-secreting pancreatic neuroendocrine tumor that developed infectious complications due to many types of pathogens in multiple organs,widespread thromboses,pulmonary embolism,and disseminated intravascular coagulation.

Nervous and Neuroendocrine regulation of the pathophysiology of cholestasis and of biliary carcinogenesis

Cholangiocytes, the epithelial cells lining the biliary ducts, are the target cells in several liver diseases. Cholangiopathies and cholangiocarcinoma generate interest in many scientists since the genesis. The developing mechanisms, and the therapeutic tools of these diseases are still undefined. Several studies demonstrate that many hormones, neuropeptides and neurotransmitters regulate malignant and non-malignant cholangiocyte pathophysiology in the course of chronic biliary diseases. The aim of this review is to present the findings of several studies published in the recent years that contributed to clarifying the role of nervous and neuroendocrine regulation of the pathophysiologic events associated with cholestasis and cholangiocarcinoma development. This manuscript is organized into two parts. The first part offers an overview of the innervation of the liver and the origin of neuroendocrine hormones, neurotransmitters and neuropeptides affecting cholangiocyte function and metabolism. The first section also reviews the effects played by several neuroendocrine hormones and nervous system on cholangiocyte growth, survival and functional activity in the course of cholestasis. In the second section, we summarize the results of some studies describing the role of nervous system and neuroendocrine hormones in the regulation of malignant cholangiocyte growth.

Cushing’s syndrome caused by an ACTH-producing large cell neuroendocrine carcinoma of the gallbladder

Malignancies of the gallbladder, including neuroendocrine tumors, are uncommon, mostly found incidentally after cholecystectomy and are frequently asymptomatic in the early stages, but highly fatal. Limited data is available on adrenocorticotropic hormone (ACTH) producing neuroendocrine tumors specifically originating from the gallbladder. We report the clinical and radiographic findings, which included positron emission tomography and computed tomography, of a patient with a gallbladder mass who presented with Cushing’s syndrome. Subsequently, a diagnosis of ACTH-producing large cell neuroendocrine carcinoma of the gallbladder was made. Despite being rare and having a poor prognosis, hormone-producing neuroendocrine tumors should be part of the differential diagnosis in the approach of patients with Cushing’s syndrome.

Intracerebroventricular leptin injection affects neuroendocrine reproductive axis in ovariectomized rats

BACKGROUND：Leptin regulates neuroendocrine function of the hypothalamus-pituitary-ovary axis in humans. OBJECTIVE： To verify effects of intracerebroventricular leptin injection on neuroendocrine function of the hypothalamus-pituitary-ovary axis in ovariectomized rats. DESIGN, TIME AND SETTING： A randomized, controlled experiment was performed at the Basic Medical Institute, Chengde Medical College between June and October 2007. MATERIALS： Thirty healthy, female, Wistar rats were included in this study. The following compounds were used： leptin; gonadotropin-releasing hormone （GnRH） and luteinizing hormone （LH） enzyme-linked immunosorbent assay kits. METHODS： Rats were randomly divided into 3 groups at 1, 2, and 4 hours after injection. Each group was subdivided into control and experimental groups （n = 5 animals per group and time point）. All rats were subjected to bilateral ovariectomy and, beginning on day 7 after surgery, animals received daily subcutaneous injections of estradiol benzoate （2 μg） for 7 consecutive days. The experimental groups were injected with 5 μL leptin （1 g/L） into the lateral cerebral ventricle, and control groups received an equal volume of physiological saline. MAIN OUTCOME MEASURES： GnRH and LH secretion were examined 1, 2, and 4 hours after injection using GnRH and LH ELISA kits, respectively. RESULTS： In the experimental groups, GnRH secretion significantly increased （P 〈 0.01）, followed by LH secretion （P 〈 0.01）, compared with the control groups. GnRH secretion significantly increased 1 hour after leptin injection （P 〈 0.01）. The LH increase was less pronounced, but still significant （P 〈 0.01）; however, the most prominent LH increase occurred between 1 and 2 hours. Both GnRH and LH secretion reached peak levels at 2 hours after leptin injection. Thereafter, both GnRH and LH secretion decreased, but still maintained very high levels, compared with the control group （P 〈 0.01）. CONCLUSION： Intracerebroventricular leptin injection produced similar effects on GnRH and LH secretion in ovariectomized rats, indicating regulatory effects of leptin on GnRH and LH secretion.

Potential new applications of immunotherapy for neuroendocrine neoplasms:immune landscape,current status and future perspectives

Neuroendocrine neoplasms(NENs)are a highly heterogeneous class of tumors arising from neuroendocrine cells and peptidergic neurons.After failure of first-line treatment,patients have poor prognosis and limited treatment options.Immune checkpoint inhibitors(ICIs)may be a powerful means of increasing therapeutic efficacy for such patients,but ICIs alone have low response rates and short disease control durations in most NENs and may be effective for only a portion of the population.ICIs combined with other immunotherapies,targeted therapies,or cytotoxic drugs have achieved some efficacy in patients with NENs and are worthy of further exploration to assess their benefits to the population.In addition,accumulating experimental and clinical evidence supports that the interaction between neuroendocrine and immune systems is essential to maintain homeostasis,and assessment of this broad neuroendocrine-immune correlation is essential for NEN treatment.In this review,we summarize the immune microenvironment characteristics,advances in immunotherapy,predictive biomarkers of ICI efficacy for NENs,and the effects of common endocrine hormones on the immune system,highlighting possible new application areas for this promising treatment in neglected NENs.

Neuroendocrine Differentiation in the Progression of Prostate Cancer: An Update on Recent Developments

Neuroendocrine (NE) differentiation, either benign or malignant, is the hallmark of prostate cancer (PCa). Clusters of malignant NE cells are found in most prostate cancer cases. NE differentiation is among the non-mutually exclusive theories proposed to explain the progression to androgen independence of PCa. NE differentiation is usually associated with an increased aggressivity and invasiveness of prostate tumors and a poor prognosis. This review aims to present an overview of current knowledge on neuroendocrine differentiation in PCa to improve our understanding of tumour progression and androgen independence. The NE component represents an important therapeutic axis. Development of new generation of drugs that selectively target NE-like cells may lead to the development of new therapeutic modalities for advanced and hormone-refractory PCa.

抑郁症与甲状腺激素的研究进展

抑郁症发病机制十分复杂,至今尚无明确定论,其中神经内分泌假说认为,抑郁症发病与人体下丘脑-垂体-肾上腺轴或甲状腺轴功能异常有关。近年来,随着抑郁症与神经内分泌功能之间的关系被临床研究证实,神经内分泌假说逐渐被认可,然而这些研究结论之间仍存在许多矛盾与争议。为探究抑郁症与甲状腺激素的相关性及相关机制,本文将目前国内外抑郁症的治疗与甲状腺激素的相关研究作一综述。

血清甲状腺激素水平与气血两虚型癌因性疲乏的相关性研究

目的调查分析气血两虚型肿瘤患者癌因性疲乏(CRF)现状,探究CRF及其不同严重程度与患者甲状腺功能的相关性。方法纳入2019年10月至2022年5月就诊于全国19家分中心的气血两虚型CRF患者142例,采用Piper疲乏修订量表中文版评估患者疲乏状态。记录患者性别、年龄、家庭月收入、受教育程度、工作性质等人口学资料,以及体重指数(BMI)、卡诺夫斯凯计分(KPS)、癌种及病理分级、实体瘤疗效评价结果、肿瘤目前分期、中医症状、总三碘甲状腺原氨酸(TT_(3))、总甲状腺素(TT_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)水平。根据疲乏状态评分将研究对象分为轻度疲乏组(32例)、中度疲乏组(92例)、重度疲乏组(18例),比较三组基线资料,采用有序logistic回归分析探讨气血两虚型CRF程度的影响因素。结果三组性别、年龄、癌种、家庭月收入水平、受教育程度、肿瘤疗效评价、BMI、工作性质、病理分级、当前分期比较,差异无统计学意义(P>0.05)。三组KPS评分比较,差异有统计学意义(P<0.05),其中重度疲乏组KPS评分低于轻、中度疲乏组,中度疲乏组KPS评分低于轻度疲乏组(P<0.05)。三组FT_(3)、TT_(3)水平比较,差异有统计学意义(P<0.05),其中重度疲乏组FT3水平低于轻度疲乏组,TT_(3)水平低于轻、中度疲乏组,中度疲乏组TT_(3)水平低于轻度疲乏组(P<0.05)。三组FT_(4)、TT_(4)、TSH水平比较,差异无统计学意义(P>0.05)。三组中医症状数目及面色淡白或萎黄、少气懒言、头晕、自汗症状比较,差异无统计学意义(P>0.05)。三组心悸症状比较,差异有统计学意义(P<0.05),其中重度疲乏组中心悸患者所占比例高于轻、中度疲乏组(P<0.05)。有序logistic回归分析显示,TT_(3)水平(OR=0.167)、FT_(4)水平(OR=0.785)、KPS评分(OR=0.884)、无心悸症状(OR=0.249)、癌种为非小细胞肺癌(OR=3.579)是气血两虚型CRF患者疲乏程度的影响因素(P<0.05)。结论气血两虚型CRF与下丘脑-垂体-甲状腺轴的神经内分泌有关。低血清甲状腺激素水平是CRF患者高疲乏程度的危险因素,临床工作中应重视对肿瘤患者甲状腺功能的监测。

神经内镜辅助下经鼻蝶窦手术治疗垂体瘤的效果及对嗅觉功能、神经内分泌激素水平的影响

目的:探讨神经内镜辅助下经鼻蝶窦手术治疗垂体瘤的效果及对嗅觉功能、神经内分泌激素水平的影响。方法:回顾性将我院2018年03月至2022年02月收治的垂体瘤患者58例作为此次的研究对象,其中采用显微镜辅助下进行经鼻蝶窦手术的28例作为对照组,神经内镜辅助下进行经鼻蝶窦手术的30例作为观察组,均观察至患者出院,并进行随访1年。比较两组围术期指标,术后1个月视力下降、头痛及性功能障碍缓解率,术前、术后1个月激素水平、T细胞亚群、生活质量评分、嗅觉功能,研究期间并发症发生情况,随访1年后复发情况。结果:与对照组比较,观察组的出血量相对更少,术后住院时间较短,肿瘤全切率相对更高;术后1个月,与对照组进行比较,观察组视力下降、头痛及性功能障碍缓解率均相对更高;相比术前,两组术后1个月血清泌乳素(PRL)、促甲状腺素(TSH)、生长激素(HGH)、促肾上腺皮质激素(ACTh)水平均降低,观察组低于对照组,外周血CD3^(+)、CD4^(+)水平、CD4^(+)/CD8^(+)值、社会功能、躯体功能、心理功能、物质生活状态各项生活质量评分术后1个月则均升高,观察组高于对照组;与术前比较,两组术后1个月嗅觉功能均升高,但观察组低于对照组;研究期间,观察组并发症总发生率3.33%低于对照组的25.00%;随访1年后,观察组的复发率0.00%同样低于对照组的14.29%(P<0.05)。结论:神经内镜辅助下经鼻蝶窦手术可有效提高垂体瘤患者的生活质量以及视力下降、头痛等临床症状缓解率,缩短住院时间,同时还能够改善患者的免疫功能以及嗅觉功能,稳定患者神经内分泌激素水平,降低并发症发生以及复发率。

老年衰弱发病机制的研究进展

老年衰弱是老年人面临的一种复杂综合征,其特征是机体多器官系统生理储备降低和失调使机体自稳能力下降,导致日常活动能力的减弱和生活质量的下降。随着人口老龄化,衰弱正逐渐成为威胁老年人群健康的公共卫生问题,严重影响老年人的生活质量和临床结局。老年衰弱的发病机制是一个复杂过程,包括炎症反应、细胞衰老、肠道菌群紊乱、胰岛素抵抗、神经内分泌失调等多方面的影响。该文对老年衰弱发病机制进行了综述,为识别衰弱危险因素、制定相应预防和干预策略、延缓老年衰弱、改善老年人生活质量提供线索和依据。

化痰活血通脉方联合心脏康复运动治疗慢性心力衰竭痰瘀互结型患者的临床研究

目的观察化痰活血通脉方联合心脏康复治疗对痰瘀互结型慢性心力衰竭患者的临床疗效。方法选取2021年6月—2022年6月期间就诊于安徽中医药大学第二附属医院心血管内科诊断为痰瘀互结型慢性心力衰竭患者70例作为研究对象,按随机数字表法分为对照组和治疗组,每组各35例。两组患者均予以规范西药治疗,对照组联合心脏康复治疗,治疗组在对照组基础上加服化痰活血通脉方。治疗12周后,观察比较两组患者临床疗效、不良反应情况,治疗前后神经内分泌激素[肾素(Renin,REN)、醛固酮(Aldosterone,ALD)、血促肾上腺皮质激素(Adrenocorticotrophic hormone,ACTH)、血管紧张素II(AngiotensinⅡ,Ang II)]、明尼苏达心力衰竭生命质量量表(Minnesota living with heart failurequestionnaire,MLHF-Q)、NT-proBNP(N-terminal pro-brain natriuretic peptide,NT-proBNP)、6 min步行距离(6-minute walk distance,6MWD)、LVEF(Left ventricular ejection fraction,LVEF)、AT(Anaerobic threshold,AT)、V02max(Maximum oxygen uptake)、Power、中医证候积分变化。结果治疗后两组患者神经内分泌激素REN、ALD、ACTH、Ang II均较治疗前降低,差异有统计学意义(P<0.05);且治疗组神经内分泌激素REN、ALD、ACTH、Ang II均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MLHF-Q评分、NT-proBNP水平较治疗前明显降低,6MWD、LVEF水平均较治疗前明显升高,差异有统计学意义(P<0.05);且治疗组MLHF-Q评分、NT-proBNP水平较对照组明显降低,6MWD、LVEF水平均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者AT、V02max、Power水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组AT、V02max、Power水平均高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.01);且治疗组中医证候积分低于对照组,差异有统计学意义(P<0.01)。治疗后治疗组总有效率97.14%(34/35)明显高于对照组82.86%(29/35),差异有统计学意义(χ2=3.968,P<0.05)。治疗期间,两组患者均未发现明显不良反应。对照组发生低血压1例,干咳1例;治疗组发生皮疹1例。两组间比较,差异无统计学意义(P>0.05)。结论化痰活血通脉方联合心脏康复治疗痰瘀互结型慢性心力衰竭,可显著改善患者临床症状,很大程度提高患者心功能和抑制神经内分泌激素过度激活。

艾灸对衰老过程中下丘脑-垂体-性腺轴的调节作用研究

衰老是机体各组织、器官功能随增龄而发生的退行性变化,是任何生命过程不可抗拒的必然规律。在衰老的现代医学研究中,神经内分泌尤其是下丘脑-垂体-性腺(HPG)轴的紊乱衰老是衰老学说的重要内容。艾灸作为延年保健、补肾抗衰老的重要方法,在调节神经内分泌方面具有独特优势。现以机体衰老过程中HPG轴的变化为线索,对近10年艾灸治疗衰老性疾病的相关文献进行综述,探讨艾灸补肾抗衰老的现代物质基础,为艾灸在临床中治疗衰老性疾病提供新的思路和理论依据。

奖赏系统运动依赖可塑性与肥胖控制:食欲相关神经内分泌激素介导的调节作用

从多巴胺神经传递障碍与肥胖的发生发展关系、大脑奖赏系统运动依赖可塑性及多种食欲相关神经内分泌激素的关键作用等多方面研究现状进行了归纳综述,并对运动防治肥胖的靶向中枢奖赏系统研究前景进行展望,论述并分析了奖赏系统在运动防治肥胖的神经生物学潜在机制中的作用。

心脉隆注射液联合贝那普利治疗高血压伴心力衰竭的疗效探讨

目的探讨心脉隆注射液联合贝那普利治疗高血压伴心力衰竭的临床疗效。方法方便选取2021年1月—2023年2月如皋市人民医院心血管内科收治的110例高血压伴心力衰竭患者为研究对象,按照随机数表法分为对照组和研究组,各55例。两组均给予常规抗心衰治疗,在此基础上对照组给予贝那普利治疗,研究组给予心脉隆注射液联合贝那普利治疗,两组均连续治疗14 d。比较两组患者血压、超声心功能指标、神经内分泌激素水平及临床疗效。结果治疗后,研究组的收缩压、舒张压低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组的左心室射血分数、左心室舒张早期和晚期充盈速度比值高于对照组,而左心室舒张末期内径、左室收缩末内径低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组的去甲肾上腺素、醛固酮、血管紧张素Ⅱ、肾素活性水平低于对照组,差异有统计学意义(P<0.05)。研究组的治疗总有效率(89.09%)高于对照组(72.73%),差异有统计学意义(χ^(2)=4.767,P<0.05)。结论心脉隆注射液联合贝那普利治疗高血压伴心力衰竭的疗效更好,可有效控制患者的血压,降低神经内分泌激素水平,改善患者心功能。

腹腔镜剔除术治疗卵巢良性肿瘤的效果及对患者性激素和神经内分泌激素及疼痛应激的影响

目的探究腹腔镜剔除术治疗卵巢良性肿瘤的效果及对患者性激素、神经内分泌激素及疼痛应激的影响。方法选取2018年1月至2020年1月丰城市人民医院收治的80例卵巢良性肿瘤患者作为研究对象,按照治疗方式不同分为两组,各40例。对照组予以常规开腹治疗,观察组予以腹腔镜剔除术治疗,比较两组手术前后神经内分泌激素[皮质醇(Cor)、β-内啡肽(β-EP)、胰高血糖素(GC)]水平、疼痛应激[前列腺素E_(2)(PGE_(2))、白细胞介素-6(IL-6)、血清P物质(SP)]水平、性激素[促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))]水平及临床疗效。结果术后,两组Cor、β-EP、GC水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。术后,两组PGE_(2)、IL-6、SP水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。术后,两组FSH、LH水平均高于术前,E_(2)水平均低于术前,但观察组FSH、LH水平均低于对照组,E_(2)水平高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为97.50%,明显高于对照组的80.00%,差异有统计学意义(P<0.05)。结论采用腹腔镜剔除术治疗卵巢良性肿瘤,可有效缓解手术机械性刺激对神经内分泌激素、疼痛应激、性激素水平的影响,临床疗效确切,值得临床推广应用。

rhBNP联合沙库巴曲缬沙坦对急性心力衰竭患者心功能及神经内分泌激素水平的影响

目的:探究联合使用重组人脑利钠肽(rhBNP)与沙库巴曲缬沙坦对急性心力衰竭(AHF)患者心功能及神经内分泌激素水平的影响。方法:选取兴山县人民医院2020~2021年收治的100例AHF患者为研究对象,按照简单随机化法将研究对象1∶1分为观察组50例和对照组50例,两组患者均常规使用扩血管药物进行降压治疗,对照组在此用药基础上加用沙库巴曲缬沙坦,观察组在对照组基础上加用rhBNP,比较两组治疗前、后心功能指标、神经内分泌细胞因子及炎性因子水平,两组用药后不良反应发生率的差异。结果:治疗后,两组左心室舒张末期容积(LVEDV),左心室收缩末期容积(LVESV)、血浆醛固酮(ALD)、心房钠尿肽(ANP)、心肌肌钙蛋白(cTnI)、白细胞介素-6及C反应蛋白水平均比治疗前下降,左心室射血分数(LVEF)比治疗前升高,且观察组LVEDV,LVESV、ALD、ANP、cTnI、白细胞介素-6及C反应蛋白水平比对照组更低,LVEF比对照组更高,差异均有统计学意义(P<0.05)。结论:rhBNP联合沙库巴曲缬沙坦对AHF患者的心功能有明显改善作用,可有效缓解心肌损伤,并能调节其神经内分泌系统,从而缓解炎性反应,药物方案安全性良好。

沙库巴曲缬沙坦钠对冠心病合并慢性心力衰竭患者神经内分泌激素及血液流变学的影响

目的:观察沙库巴曲缬沙坦钠对冠心病合并慢性心力衰竭患者神经内分泌激素及血液流变学的影响。方法:研究对象选择92例上饶市铅山县妇幼保健院于2019年6月至2022年5月期间收治的冠心病合并慢性心力衰竭患者,以随机信封法分为观察组(46例)和对照组(46例),在常规治疗基础上,对照组采用缬沙坦治疗,观察组采用沙库巴曲缬沙坦钠治疗,两组连续治疗一个月后,采用酶联免疫吸附法、全自动血液粘度动态分析等观察两组患者神经内分泌激素、血液流变学指标的变化与不良反应发生情况。结果:治疗后,两组去甲肾上腺素、血管紧张素II、血清醛同酮、水平均降低,观察组上述神经内分泌激素水平明显低于对照组(P<0.05);治疗后,两组血细胞比容、血浆黏度、纤维蛋白原水平均改善,观察组三项血液流变学指标改善程度优于对照组(P<0.05);治疗期间,两组患者发生低血压、头晕、恶心腹泻、高血钾症等不良反应发生情况总数相近(P>0.05)。结论:沙库巴曲缬沙坦钠对冠心病合并慢性心力衰竭患者神经内分泌激素及血液流变学具有较好改善作用,且具有较高安全性。