脑心通胶囊对心力衰竭患者心功能及血浆脑钠肽的影响

目的:观察脑心通胶囊对冠心病合并慢性心力衰竭患者心功能及血浆脑钠肽的影响。方法:对照组给予利尿剂、抗感染、β-受体阻滞剂等常规治疗,治疗组在常规治疗基础上加用脑心通胶囊。结果:治疗组血浆BNP水平较对照组下降明显(P<0.05),LVEDD、LVEF、心功能改善有效率均优于对照组。结论:脑心通辅助治疗冠心病心力衰竭安全有效,值得临床推广。

芪苈强心胶囊对充血性心力衰竭患者血清APN、BNP及心功能的影响

目的:探究芪苈强心胶囊对充血性心力衰竭(CHF)患者血清血清脂联素(APN)、脑钠肽(BNP)及心功能的影响,为临床研究提供参考依据。方法:选择我院收治的CHF患者201例为研究对象,采用随机数字法将其分为治疗组102例和对照组99例;所有患者均给予血管紧张素转换酶抑制剂、利尿剂、硝酸酯类药物等进行常规治疗,治疗组在此基础上给予芪苈强心胶囊。观察两组患者治疗前后心功能改善情况、血清BNP、APN变化情况,评价两组治疗效果。结果:治疗后两组左室收缩末期内径(LVESD)、左室舒张末内径(LVEDD)水平较治疗前均显著降低,左室射血分数(LVEF)水平显著升高,且治疗组LVEDD、LVESD水平低于对照组,LVEF水平显著高于对照组(P<0.05);治疗组总有效率为86.27%,对照组为76.77%,治疗组显著高于对照组(P<0.05);治疗后两组血清BNP、APN水平均显著降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论:芪苈强心胶囊在改善CHF患者心功能上具有显著的疗效,其能够降低患者血清APN、CHF水平。

Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

Background The neutrophil-to-lymphocyte （N/L） ratio has been associated with poor prognosis in patients with heart failure, but it has not been compared with N-terminal pro-brain natriuretic peptide （NT-proBNP） in elderly patients with chronic heart failure （CHF）. We sought to make this comparison. Methods A total of 1355 elderly patients with CHF were analyzed. A multivariate logistic regression model was used to analyze the variables associated with atrial fibrillation （AF）. Cox regression analysis was used to assess the multivariable rela- tionship between the N/L ratio, NT-proBNP level, and subsequent major cardiovascular events （MCE）. Results In the multiple logistic regression analysis, the N/L ratio was demonstrated as a risk factor for AF in elderly patients with CHF [odds ratio （OR）： 1.079, 95% confi- dence interval （CI）： 1.027-1.134, P = 0.003]. The median follow-up period was 18 months. In a multivariable model using tertiles of both variables, the highest tertile of the N/L ratio was significantly associated with MCE [hazard ratio （HR）： 1.407, 95% CI： 1.098-1.802, P = 0.007] compared with the lowest tertile. Similarly, the highest NT-proBNP tertile was also significantly associated with MCE （HR： 1.461, 95% CI： 1.104-1.934, P- 0.008）. Conclusions In elderly patients with CHF, the N/L ratio is one of the important risk factors for AF and it is an inexpensive and readily available marker with similar independent prognostic power to NT-proBNP. The risk of MCE increases 1.407-fold when the N/L ratio is elevated to the highest tertile.

Plasma brain natriuretic peptide level in older outpatients with heart failure is associated with physical frailty, especially with the slowness domain

Objective To determine the association between plasma brain natriuretic peptide （BNP） level in patients with heart failure （HF） and physical frailty as well as with each domain of physical frailty. Methods Two hundred and six outpatients of cardiovascular medicine aged 60 years and older who had been hospitalized for HF or had been given a prescription medication for HF were included. Physical frailty was assessed using the following five domains： slowness, weakness, exhaustion, low activity, and shrinking, according to the Cardiovascular Health Study. Patients were divided into nonfi-ailty and frailty groups according to frailty scores. Plasma BNP level was measured. The 6-min walk test was performed to measure endurance. Results Plasma BNP was significantly different between the two groups （frailty group： 158.0 i 214.7 pg/mL, nonfrailty group： 65.2 ~ 88.0 pg/mL, P 〈 0.01）. Multivariate logistic regression analysis revealed log-transformed plasma BNP （Log BNP） was significantly associated with physical frailty （OR： 1.68, 95% CI： 1.11-2.56）, and Log BNP was significantly associated with the slowness domain （walking speed 〈 1.0 m/s） of physical frailty （OR： 1.75, 95% Ch 1.15-2.67）. Additionally, Log BNP was negatively correlated to the 6-minute walk distance （6MWD） （p=0.37, P 〈 0.01）, while 6MWD was positively correlated to walking speed （p = 0.66, P 〈 0.01）. Conclusions Plasma BNP level was related to physical frailty, especially in the slowness domain. Endurance may intervene in the associations between plasma BNP level and walking speed.

High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia

AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls. RESULTS: Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as thepatients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.