Lyophilized recombinant human brain natriuretic peptide for chronic heart failure:Effects on cardiac function and inflammation

BACKGROUND Chronic heart failure(CHF)is a serious and prevalent condition characterized by impaired cardiac function and inflammation.Standard therapy for CHF has limitations,prompting the exploration of alternative treatments.Recombinant human brain natriuretic peptide(BNP)has emerged as a potential therapy,with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with CHF.However,further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory status.This study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients’cardiac function and microinflammatory status.AIM To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with CHF.METHODS In total,102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups(n=51 patients/group).The control patients were treated with standard HF therapy for 3 d,whereas the observational patients were injected with the recombinant human BNP for 3 d.Clinical efficacy,inflammatory factor levels,myocardial damage,cardiac function before and after the treatment,and adverse reactions during treatment were compared between the two groups.RESULTS The overall clinical efficacy was higher in the observation group than in the control group.Compared with baseline,serum hypersensitive C-reactive protein,N-terminal proBNP,and troponin I level,and physical,emotional,social,and economic scores were lower in both groups after treatment,with greater reductions in levels and scores noted in the observation group than in the control group.The overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group(P>0.05).CONCLUSION Freeze-dried recombinant human BNP therapy can improve heart function and enhance microinflammatory status,thereby improving overall quality of life without any obvious side effects.This therapy is safe and reliable.

Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure

Lyophilized recombinant brain natriuretic peptide(BNP)is an exogenous peptide synthesized by artificial recombination technology,with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body.It’s main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body,regulating,thus,the imbalance of the vascular system and cardiac hemodynamics,improving the heart’s pumping capacity,and inhibiting sympathetic excitability and myocardial remodeling.Moreover,it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes.In the present study,102 chronic heart failure(HF)patients were randomly assigned to a control and an observation group consisting of 51 patients each.Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets,spironolactone,and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period,plus the standard HF therapy.The recombinant human BNP group(observation group)demonstrated better physical,emotional,social,and economic scores,as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein,N-terminal pro BNP and troponin I levels,compared to the control group.Moreover,cardiac function was also improved,as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group.Interestingly,adverse reactions were not different between the 2 groups.However,these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.

Effect Study of the Recombinant Human Brain Natriuretic Peptide in Patients with Heart Failure Combined with Hypotension

Objective: This paper aims to investigate the effect of applying recombinant human brain natriuretic peptide in patients with heart failure combined with hypotension. Recombinant human brain natriuretic peptide is a synthetic polypeptide drug that is primarily used to treat acute heart failure. Its mechanism of action closely mimics that of human endogenous brain natriuretic peptide. By binding to receptors on cardiomyocytes, it exerts its pharmacological effects. Methods: For the study, 76 heart failure patients with hypotension were selected from our hospital between May 2022 and June 2023. These patients were divided into two groups: a control group and an observation group, each comprising 38 patients. The control group received dopamine treatment, while the observation group was treated with recombinant brain natriuretic peptide. The objective was to compare the effects of the treatments in both groups by analyzing cardiac function indices and levels of vasoactive substances to identify any significant differences in outcomes. Results: The overall response rate of the patients in the observation group and the control group was 94.74% and 73.68%, significantly higher as compared with the observation group (P 0.05). After the following treatment, BNP, ANNP and urine output in the observation group were significantly different compared with the control group, of the statistical significance (P Conclusion: For the treatment of heart failure patients with hypotension, the clinical application of recombinant human brain natriuretic peptide is the most ideal, and significantly improves the cardiac function of patients, which is worth popularizing.

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

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.

Differential effects of atrial and brain natriuretic peptides on human pulmonary artery:An in vitro study

BACKGROUND The prevalence of cardiovascular diseases,especially heart failure,continues to rise worldwide.In heart failure,increasing levels of circulating atrial natriuretic peptide(ANP)and brain natriuretic peptide(BNP)are associated with a worsening of heart failure and a poor prognosis.AIM To test whether a high concentration of BNP would inhibit relaxation to ANP.METHODS Pulmonary arteries were dissected from disease-free areas of lung resection,as well as pulmonary artery rings of internal diameter 2.5–3.5 mm and 2 mm long,were prepared.Pulmonary artery rings were mounted in a multiwire myograph,and a basal tension of 1.61gf was applied.After equilibration for 60 min,rings were pre-constricted with 11.21μmol/L PGF2α(EC80),and concentration response curves were constructed to vasodilators by cumulative addition to the myograph chambers.RESULTS Although both ANP and BNP were found to vasodilate the pulmonary vessels,ANP is more potent than BNP.pEC50 of ANP and BNP were 8.96±0.21 and 7.54±0.18,respectively,and the maximum efficacy(Emax)for ANP and BNP was-2.03 gf and-0.24 gf,respectively.After addition of BNP,the Emax of ANP reduced from-0.96gf to-0.675gf(P=0.28).CONCLUSION BNP could be acting as a partial agonist in small human pulmonary arteries,and inhibits relaxation to ANP.Elevated levels of circulating BNP could be responsible for the worsening of decompensated heart failure.This finding could also explain the disappointing results seen in clinical trials of ANP and BNP analogues for the treatment of heart failure.

不同剂量重组人脑利钠肽联合比索洛尔在老年急性心肌梗死患者PCI后的应用对比

目的 比较不同剂量的重组人脑利钠肽(rhBNP)联合比索洛尔在老年急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后的应用价值。方法 选取2020年1月—2022年10月秦皇岛市第一医院收治的138例老年AMI患者进行前瞻性研究,按照随机数字表法分为三组,各46例。各组均行PCI和比索洛尔治疗,术前2 h,小剂量组给予1.5μg/(kg·min)的rhBNP,中剂量组给予2.0μg/(kg·min)的rhBNP,大剂量组给予3.0μg/(kg·min)的rhBNP。比较各组治疗前后心功能[左室射血分数(LVEF)、心脏指数(CI)、每分钟搏出量(SV)、血浆脑钠肽(BNP)]、心电生理指标[窦性心搏RR间期标准差(SDNN)、相邻RR间期差值均方根(RMSSD)、低频段/高频段(LF/HF)]、肾功能[血肌酐(Scr)、β2-微球蛋白(β2-MG)、血尿素氮(BUN)]、核因子E2相关因子2/血红素加氧酶-1(Nrf2/HO-1)通路及治疗后不良反应、心血管不良事件的发生情况。结果 治疗72 h后,大剂量组LVEF、CI、SV、SDNN、RMSSD及Nrf2、HO-1蛋白水平均高于中剂量组和小剂量组(P<0.05),大剂量组的血浆BNP水平、LF/HF低于中剂量组和小剂量组(P<0.05);治疗72 h后,中剂量组和小剂量组的心功能、心电生理指标、Nrf2/HO-1信号通路的蛋白比较差异均无统计学意义(P>0.05)。治疗前、治疗72 h后,各组血清Scr、β2-MG、BUN水平比较差异均无统计学意义(P>0.05),各组不良反应总发生率、心血管不良事件的总发生率比较差异均无统计学意义(P>0.05)。结论 rhBNP联合比索洛尔应用于老年AMI患者PCI后疗效确切,大剂量rhBNP可显著改善心功能、心率变异性,可能与激活Nrf2/HO-1通路有关,且对肾功能损害、不良反应及心血管不良事件无明显影响。

重组人脑利钠肽治疗射血分数保留心力衰竭患者的疗效

目的:探讨重组人脑利钠肽治疗射血分数保留心力衰竭患者的疗效和安全性,以及患者用药后sST2及N末端B型利钠肽原(NT-proBNP)水平变化。方法:选取包头市第四医院2020年2月-2022年2月收治射血分数保留心力衰竭患者60例,按照是否接受重组人脑利钠肽治疗分为观察组(联合注射用重组人脑利钠肽治疗)30例及对照组(常规治疗)30例,观察两组治疗前、治疗72 h后,6 min步行试验(6 MWT)、血清sST2和NT-proBNP水平、超声心动图指标及临床疗效。结果:治疗72 h后,观察组6 MWT高于对照组,NT-proBNP水平低于对照组(P<0.05);治疗72 h后,观察组左心房容积指数(LAVI)低于对照组,左心室射血分数(LVEF)升高(P<0.05);观察组总有效率高于对照组(P<0.05);治疗72 h后,观察组血清sST2水平降低(P<0.05)。结论:注射用重组人脑利钠肽可改善射血分数保留心力衰竭患者的心肌功能,增加心脏排血量,减轻心肌细胞损伤,经sST2及NT-proBNP水平评估后确保有效,且临床用药安全性好,建议推广。

重组人脑利钠肽对急性失代偿性心力衰竭的疗效及相关指标的影响探讨

目的观察重组人脑利钠肽(rhBNP)对急性失代偿性心力衰竭的疗效及相关指标的影响。方法78例急性失代偿性心力衰竭患者,根据治疗方案差异分成对照组与观察组,每组39例。对照组采取常规治疗,观察组在对照组基础上加用重组人脑利钠肽治疗。比较两组治疗前后临床症状评分、炎性介质水平、血管内皮功能、心功能指标及生存质量。结果治疗后,两组呼吸困难、下肢水肿、入睡困难、喘息不止、颈静脉怒张评分较治疗前更低,且观察组呼吸困难、下肢水肿、入睡困难、喘息不止、颈静脉怒张评分分别为(1.05±0.26)、(1.43±0.25)、(0.77±0.21)、(1.51±0.45)、(1.29±0.62)分,较对照组的(2.52±0.89)、(2.31±0.67)、(1.07±0.38)、(2.12±0.36)、(2.31±0.72)分更低(P<0.05)。治疗后,两组肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平较治疗前更低,且观察组肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平分别为(0.43±0.15)pg/L、(8.86±1.51)pg/ml、(8.10±1.15)mg/L,较对照组的(0.61±0.11)pg/L、(10.51±1.62)pg/ml、(10.32±1.22)mg/L更低(P<0.05)。治疗后,两组一氧化氮、内皮素-1水平较治疗前更低,且观察组一氧化氮水平(53.81±7.92)μmol/L、内皮素-1水平(40.91±2.30)ng/L较对照组的(60.46±6.42)μmol/L、(52.16±3.63)ng/L更低(P<0.05)。两组治疗后左心室射血分数、心输出量、心脏指数较治疗前更高,左心室舒张末期内径、左心室收缩末期内径较治疗前更小,且观察组左心室射血分数、心输出量、心脏指数较对照组更高,左心室舒张末期内径、左心室收缩末期内径较对照组更小(P<0.05)。两组治疗后生理、心理、社会关系、环境评分较治疗前更高,且观察组较对照组更高(P<0.05)。结论采用重组人脑利钠肽治疗急性失代偿性心力衰竭效果显著,其能够改善患者临床相关症状及血管内皮功能,有助于心功能早日恢复至健康状态。

沙库巴曲缬沙坦联合冻干重组人脑利钠肽治疗心力衰竭的疗效及对NT-proBNP的影响

目的探讨沙库巴曲缬沙坦联合冻干重组人脑利钠肽治疗心力衰竭的疗效及对NT-proBNP的影响。方法选取2022年4月至2023年5月云南省昆明市第一人民医院心内科收治的150例心力衰竭患者为研究对象,根据就诊时间分为两组。参照组采用沙库巴曲缬沙坦治疗,实验组在参照组基础上使用冻干重组人脑利钠肽治疗。对比两组治疗效果、心功能、血浆BNP、NT-proBNP水平及不良反应发生情况。结果实验组治疗总有效率高于参照组,差异有统计学意义(P<0.05)。实验组干预后心率低于参照组,每搏量及LVEF均高于参照组,差异有统计学意义(P<0.05)。实验组干预后血浆BNP、NT-proBNP水平均低于参照组,差异有统计学意义(P<0.05)。实验组不良反应发生率低于参照组,差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦联合冻干重组人脑利钠肽治疗心力衰竭可显著提高疗效,降低血浆BNP及NT-proBNP水平,改善患者心功能,减少不良反应。

重组人脑利钠肽联合双水平气道正压通气治疗重症AHF患者的疗效及对心功能、血流动力学及抗氧化指标的影响

目的 研究重组人脑利钠肽联合双水平气道正压通气治疗重症急性心力衰竭(AHF)患者的疗效及对心功能、血流动力学及抗氧化指标的影响。方法 对2020年6月至2022年6月上海市浦东新区人民医院收治的107例重症AHF患者的临床急救资料进行回顾性分析。根据急救方法不同将其分为对照组(n=51)和联合组(n=56)。所有患者均进行强心、利尿、抗感染等常规急救措施,对照组采用双水平气道正压通气,联合组采用双水平气道正压通气联合重组人脑利钠肽治疗。统计分析两组治疗前后的临床疗效、治疗前和治疗72 h后的心功能指标[左室射血分数(LVEF)、左心室收缩末期容积(LVESV)、N末端B型利尿钠肽原(NT-proBNP)]、血流动力学指标[心率、平均动脉压(MAP)、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))]、抗氧化指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)]水平,并记录两组患者的撤机时间及24 h尿量。结果 联合组的临床总有效率为91.07%,明显高于对照组(78.43%),差异有统计学意义(P<0.05)。治疗72 h后,联合组患者LVEF为(55.13±4.45)%,显著高于对照组[(47.96±4.75)%],LVESV、NT-proBNP分别为(53.61±5.45) mL、(1 848.43±209.31) ng/L,均显著低于对照组[(69.14±5.37) mL、(2 731.35±221.57) ng/L],差异均有统计学意义(P<0.05)。治疗72 h后,联合组患者心率及MAP、PaCO_(2)水平分别为(86.75±10.52)次/min、(89.32±1.25) mmHg、(40.24±3.63) mmHg,均显著低于对照组[(98.18±8.65)次/min、(100.74±2.15) mmHg、(48.02±3.97) mmHg],PaO_(2)水平为(69.37±5.07)mmHg,高于对照组[(59.16±5.34) mmHg],差异均有统计学意义(P<0.05)。治疗72 h后,联合组患者SOD、CAT、GSH-Px水平分别为(558.16±54.35)μg/g、(281.07±45.69)μg/g、(55.34±4.14)U/L,均显著高于对照组[(479.67±55.14)μg/g、(229.81±45.62)μg/g、(41.05±4.91) U/L],差异均有统计学意义(P<0.05)。联合组患者撤机时间为(22.31±5.81) h,短于对照组[(29.05±6.63) h],24 h尿量为(1 628.85±138.92) mL,大于对照组[(1 337.95±110.59) mL],差异均有统计学意义(P<0.05)。结论 重组人脑利钠肽联合双水平气道正压通气用于重症AHF衰竭急救临床疗效显著,可有效改善患者心功能、血流动力学及抗氧化指标,对促进钠排泄和缩短撤机时间更为有利。

新活素联合多巴胺治疗毛细血管前肺动脉高压所致右心衰竭的疗效观察

目的观察新活素联合多巴胺治疗毛细血管前肺动脉高压所致右心衰竭的临床疗效。方法选取于2022年2月至2022年12月秦皇岛市第一医院收治的毛细血管前肺动脉高压所致右心衰竭患者104例。随机分为对照组(抗右心衰竭常规治疗)34例、A组(常规治疗+新活素持续静脉滴注)33例、B组(常规治疗+新活素持续静脉滴注+多巴胺静脉滴注)37例。比较各组治疗前后血脑钠肽(BNP)值、右心室面积变化分数(FAC)、三尖瓣环收缩期位移(TAPSE)、右心室心脏指数(RCI)、肺动脉平均压(PAMP)及治疗中低血压发生率。结果三组基线数据对比无统计学差异。BNP值:治疗后三组均下降,A组、B组低于对照组(P<0.05),B组低于A组(P<0.05),三组间存在统计学差异(F=41.2,P<0.01)。FAC、TAPSE、RCI:治疗后三组均升高,A组、B组高于对照组(P<0.05),B组高于A组(P<0.05),三组间存在统计学差异(FFAC=41.6,FTAPSE=48.0,FRCI=183.1,P均<0.01)。PAMP:治疗后三组均下降,A组、B组低于对照组(P<0.05),A组、B组间无统计学差异(P>0.05),三组间存在统计学差异(F=5.0,P<0.01)。低血压发生率:对照组11.8%、A组24.2%,B组2.7%,三组间有统计学差异(P=0.023)。结论新活素联合多巴胺静脉滴注可有效改善毛细血管前肺动脉高压所致右心衰竭患者的右心功能,并降低治疗中低血压的发生率。

注射用重组人脑利钠肽与左西孟旦治疗缺血性心肌病致心力衰竭的效果

目的 分析缺血性心肌病致心力衰竭患者联合使用注射用重组人脑利钠肽及左西孟旦对肺毛细血管楔压(PCWP)、肺动脉压(PAP)水平及心肌细胞功能的影响。方法 选择160例于2021年4月至2023年4月就诊在安阳市人民医院收治的缺血性心肌病致心力衰竭患者,对其行随机方法,使用方法为随机数字表法,分组结果为患者分别进入例数为80例的联合组和对照组。对照组接受左西孟旦等基础治疗,联合组在对照组基础上接受重组人脑利钠肽联合治疗。比较两组疗效。比较两组治疗前后血流动力学参数、心肌细胞功能、心功能、药物不良反应发生情况。结果 联合组治疗总有效率达93.75%,同对照组相比较更高(P<0.05)。两组PCWP、PAP及氨基末端脑钠肽前体(NT-proBNP)水平同治疗前相较均下降,且联合组相对更低(P<0.05)。两组左心射血分数(LVEF)同治疗前相较升高,左心收缩末期内径(LVESD)及左心舒张末期内径(LVEDD)通治疗前相较下降,且联合组LVEF水平相对更高,LVESD及LVEDD则相对更低(P<0.05)。联合组治疗后1个月内不良反应发生率为10.00%,较对照组不良反应总发生率差异无统计学意义(P>0.05)。结论 缺血性心肌病致心力衰竭患者联合应用重组人脑利钠肽及左西孟旦,其PCWP、PAP水平及心肌细胞功能的调节效果均得到增强,增强患者心功能改善效果,且不增加药物不良反应发生风险。

人软骨糖蛋白-39、N端脑钠肽前体在川崎病患儿冠状动脉损伤中的应用价值

目的 探讨人软骨糖蛋白-39(YKL-40)、N端脑钠肽前体(NT-proBNP)在川崎病(KD)患儿冠状动脉损伤(CAL)中的临床应用价值。方法 选取125例KD患儿作为研究对象(KD组),并根据是否合并冠状动脉病变分为CAL组(n=53)及无冠状动脉损伤(NCAL)组(n=72)。选取同期体检的健康儿童(HC组)和同期住院的仅消化道感染的发热患儿(FC组)作为对照。检测血浆YKL-40、NT-proBNP水平。绘制受试者工作特征(ROC)曲线评估YKL-40、NT-proBNP对KD患儿不同时期CAL的诊断价值。结果 KD患儿不同时期(急性期、亚急性期和恢复期)的血浆YKL-40、NT-proBNP水平高于HC组、FC组,差异有统计学意义(P<0.05);CAL组YKL-40水平高于NCAL组,急性期NT-proBNP高于NCAL组,差异有统计学意义(P<0.05)。YKL-40、NT-proBNP及两者联合诊断KD急性期CAL的曲线下面积(AUC)分别为0.813、0.832、0.886;YKL-40、NT-proBNP及两者联合诊断KD亚急性期CAL的AUC分别为0.699、0.522、0.701;YKL-40、NT-proBNP及两者联合诊断KD恢复期CAL的AUC分别为0.982、0.435、0.986。结论 血浆YKL-40和NT-proBNP水平可作为KD早期辅助诊断指标。血浆YKL-40可联合其他指标用于监测KD疾病活动及CAL并发症的发展。

急性病毒性肝炎患者心电图异常相关因素及其对预后的预测价值

目的探讨急性病毒性肝炎患者心电图异常相关因素及其对预后的预测价值。方法选取2020年2月—2023年2月收治的伴心电图异常急性病毒性肝炎78例为异常组,无心电图异常急性病毒性肝炎120例为无异常组,收集2组临床资料并分析心电图异常相关因素。随访6个月,将心电图异常78例分为预后良好组[多器官功能障碍综合征(MODS)评分≤12分]、预后不良组(MODS评分>12分),分析心电图异常相关因素对急性病毒性肝炎患者预后影响及预测价值。结果心电图异常78例心电图表现为T波改变(42.31%,33/78)、窦性心动过缓(34.62%,27/78)、窦性心动过缓伴窦性心律不齐(24.36%,19/78)等。Logistic回归分析显示,疾病类型、总胆红素(TBIL)、脑钠肽(BNP)、左心室Tei指数及伴肝硬化、伴门静脉高压是急性病毒性肝炎患者心电图异常的影响因素(P<0.05)。预后良好组、预后不良组疾病类型、TBIL、BNP、左心室Tei指数及伴肝硬化、伴门静脉高压患者所占比例比较差异有统计学意义(P<0.05)。受试者工作特征曲线显示疾病类型、TBIL、BNP、左心室Tei指数、伴肝硬化、伴门静脉高压联合预测急性病毒性肝炎患者预后的曲线下面积为0.943,大于各指标单独预测(P<0.05)。结论急性病毒性肝炎患者心电图异常与疾病类型、TBIL、BNP、左心室Tei指数、伴肝硬化、伴门静脉高压相关,且相关因素对患者预后有一定预测价值。

麝香保心丸联合人脑利钠肽对急性ST段抬高型心肌梗死患者的心肌保护作用及对动脉血流参数、ST2和IL-33的影响

目的:探讨麝香保心丸联合人脑利钠肽对急性ST段抬高型心肌梗死患者的心肌保护作用,以及对动脉血流参数、可溶性生长刺激表达基因2(ST2)和白细胞介素33(IL-33)的影响。方法:该前瞻性研究的研究时间为2021年3月至2023年3月,受试对象为105例急性ST段抬高型心肌梗死患者,共脱落5例,最后完成疗程并有完整记录的为100例。将100例患者采用随机数字表法分为研究组和对照组,每组50例。两组患者入院后均采取常规吸氧、心电监护等措施,立即建立静脉通路,并行经皮冠状动脉介入治疗;对照组患者采用注射人脑利钠肽进行治疗,研究组患者在对照组的基础上口服麝香保心丸,两组患者均连续治疗14 d。比较研究组与对照组患者治疗前后胸痛胸闷、心悸、气短、疲倦乏力、面肢浮肿和气喘等中医症状积分并比较疗效,比较研究组与对照组患者冠状动脉再通率,治疗前后心肌标志物水平、动脉血流参数以及血清ST2、IL-33、一氧化氮(NO)和内皮素-1(ET-1)水平变化。结果:治疗后,研究组患者胸痛胸闷、心悸、气短、疲倦乏力、面肢浮肿和气喘等各项中医症状积分较对照组更低,差异均有统计学意义(P<0.05)。研究组患者的治疗总有效率为96.00%(48/50),显著高于对照组的84.00%(42/50),差异有统计学意义(P<0.05)。治疗后,研究组患者血清N末端B型利钠肽前体、乳酸脱氢酶、心肌肌钙蛋白T和肌酸磷酸激酶含量较对照组更低;研究组患者冠状动脉再通率分级情况显著优于对照组;研究组患者左心室射血分数、左心室高峰充盈率、收缩期血流速度峰值、舒张期血流速度峰值和冠状动脉血流速度储备较对照组更高,左心室舒张末期内径较对照组更低;研究组患者血清ST2、IL-33和ET-1水平较对照组更低,血清NO水平较对照组更高,上述差异均有统计学意义(P<0.05)。结论:麝香保心丸联合人脑利钠肽对急性ST段抬高型心肌梗死患者的疗效较好,有助于保护心肌细胞,改善动脉血流循环,其心肌保护作用机制可能与减少ST2和IL-33的表达以及减轻血管损伤有关。

重组人脑利钠肽联合瑞舒伐他汀钙治疗心力衰竭的疗效

目的 观察重组人脑利钠肽联合瑞舒伐他汀钙治疗心力衰竭的疗效。方法 选取2021年1月—2023年6月天津市东丽区中医医院收治的心力衰竭患者56例,根据抽签法分为A组与B组,各28例。A组予以瑞舒伐他汀钙连续治疗12周,B组在A组基础上予以重组人脑利钠肽连续治疗7 d。比较2组临床疗效,治疗前后心功能指标[心排血指数(CI)、每搏输出量(SV)以及左心室射血分数(LVEF)]、心肌损伤标志物[血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)]、血脂指标(血清三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇),不良反应。结果 B组总有效率高于A组(96.43%vs. 71.43%,χ^(2)=4.766,P=0.029)。治疗12周后,2组CI、SV、LVEF升高,且B组高于A组(P<0.01);2组血清CK-MB、cTnI水平降低,且B组低于A组(P<0.01);2组血清三酰甘油、低密度脂蛋白胆固醇水平降低,血清高密度脂蛋白胆固醇水平升高,且B组降低/升高幅度大于A组(P<0.01)。B组与A组不良反应总发生率比较,差异无统计学意义(7.14%vs. 10.71%,P=1.000)。结论 心力衰竭患者接受重组人脑利钠肽联合瑞舒伐他汀钙治疗,可明显提高临床疗效和心功能,减轻心肌损伤,有效调节血脂,且不会增加不良反应发生风险。

注射用重组人脑利钠肽对急性心力衰竭患者心功能指标、再入院率及炎症因子的影响

目的探讨注射用重组人脑利钠肽对急性心力衰竭心功能指标、再入院率及炎症因子的影响。方法收集郑州大学第五附属医院2021年7月至2022年7月收治的90例急性心力衰竭患者进行研究,按随机数字表法分为两组。对照组45例接受吸氧、洛尔类药物、利尿药物、普利类药物、低盐饮食、强心剂等治疗。观察组45例在前基础上加注射用重组人脑利钠肽治疗。观察两组疗效、心功能指标[左室射血分数(LVEF)、心脏指数(CI)、心排血量(CO)]、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、N端B型钠尿肽前体(NT-proBNP)、转化生长因子-β1(TGF-β1)水平、再入院率、心率、不良反应发生率。结果观察组总有效率高于对照组(P<0.05)。干预后两组心功能指标(LVEF、CI、CO)水平提高,观察组高于对照组(P<0.05)。干预后两组IL-6、TGF-β1、NT-proBNP、hs-CRP、TNF-α水平降低,观察组低于对照组(P<0.05)。观察组再入院率、心率低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论注射用重组人脑利钠肽可改善急性心力衰竭患者的心功能,减轻炎症反应,并且能降低患者再入院率。

临床药师参与1例心力衰竭、心肌梗死合并房颤患者的药物治疗

目的梳理复杂治疗方案后的抗栓方案,重整抗栓药物和疗程,纠正不合理用药,促进合理用药。方法临床药师介入1例心力衰竭、多次因心肌梗死植入多枚支架,合并房颤,行射频消融和左心耳封堵患者的药物治疗,重整抗栓药物方案,并全程监控治疗药物,就不合理用药提出警示。结果患者明显好转,住院及出院随访期间未发生不良事件。结论临床药师的参与有助于精细化管理患者的药物治疗方案,并及时纠正不合理用药,更好的为患者服务。

左西孟旦联合新活素对慢性心力衰竭急性失代偿期患者的疗效

目的探究左西孟旦联合新活素对慢性心力衰竭急性失代偿期(acute decompensated heart failure,ADHF)患者心功能、血清脑钠肽(brain natriuretic peptide,BNP)和肌钙蛋白Ⅰ(troponinⅠ,cTnⅠ)的影响。方法选取就诊的ADHF患者100例作为研究对象,随机分为观察组和对照组,每组50例。对照组给予左西孟旦治疗,观察组给予左西孟旦联合新活素治疗,比较2组治疗后的临床疗效、纠正心力衰竭时间、住院时间和不良反应,比较2组治疗前后左心室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastopc diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、24 h尿量、BNP、cTnⅠ和超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)。结果观察组的总有效率(96.00%)高于对照组(78.00%),P<0.05;观察组的心力衰竭纠正时间和住院时间均短于对照组(P<0.05);观察组LVEF水平高于对照组,LVEDD和LVESD水平低于对照组(P<0.05);观察组BNP、cTnⅠ和hs-CRP水平均低于对照组(P<0.05);观察组的不良反应发生率(6.00%)与对照组的不良反应发生率(8.00%)比较,差异无统计学意义(P>0.05)。结论左西孟旦联合新活素可提高ADHF患者的心功能,降低血清BNP、cTnⅠ的水平。