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.

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.

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.

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.

恩格列净联合rhBNP治疗射血分数降低型心力衰竭的疗效

目的:探究恩格列净联合重组人脑利钠肽(rhBNP)治疗射血分数降低型心力衰竭(HFrEF)的疗效及对患者血清N-末端脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)和炎症因子的影响。方法:选取108例HFrEF患者为研究对象,根据治疗方式不同将患者分为对照组(n=54)和观察组(n=54)。对照组予以rhBNP治疗;观察组予以rhBNP联合恩格列净治疗。比较两组临床疗效及治疗前后心功能[左室射血分数(LVEF)、6 min步行试验(6MWT)、美国堪萨斯城心肌病患者生存质量表(KCCQ)]、心室重构[左室收缩末期内径(LVEDS)、左室舒张末期内径(LVEDD)]、血清NT-proBNP、sST2及炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6]水平。结果:观察组临床总有效率高于对照组(90.74%vs.74.07%,P<0.05)。治疗后,观察组LVEF、6MWT、KCCQ均高于对照组(P<0.05);LVEDS、LVEDD、NT-proBNP、sST2、TNF-α、IL-1β、IL-6水平均低于对照组(P<0.05)。两组不良反应发生率无统计学差异(P>0.05)。结论:恩格列净联合rhBNP治疗HFrEF的疗效和安全性均较好,可有效提高患者心功能,改善心室重构,降低血清NT-proBNP、sST和炎症因子水平。

恩格列净联合rhBNP治疗射血分数降低型心力衰竭的疗效及对患者心功能和血清FGF-21、sVEGFR-2水平的影响

目的探究恩格列净联合重组人脑利钠肽(rhBNP)治疗射血分数降低型心力衰竭(HFrEF)的疗效及对患者心功能和血清成纤维细胞生长因子-21(FGF-21)、可溶性血管内皮生长因子受体-2(sVEGFR-2)水平的影响。方法前瞻性选取2022年1月至2023年3月山东第一医科大学附属人民医院心内科收治的100例HFrEF患者为研究对象。按照随机数字表法将其分为对照组和观察组,每组各50例。对照组予以常规强心、利尿治疗及静脉泵入rhBNP,观察组在对照组基础上加用恩格列净。比较两组治疗前、治疗3个月后糖化血红蛋白(HbA1c)、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、6 min步行距离测试(6MWD)、N末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)及血清FGF-21、sVEGFR-2水平,并记录两组主要心血管不良事件(MACE)发生情况。结果观察组临床总有效率为94.00%,高于对照组(80.00%),差异有统计学意义(P<0.05)。治疗3个月后,观察组HbA1c水平为(5.34±1.51)%,低于对照组[(6.03±1.65)%],差异有统计学意义(P<0.05);两组患者的总胆固醇、LDL-C水平比较,差异均无统计学意义(P>0.05)。治疗3个月后,观察组LVEF、6MWD水平分别为(38.52±7.24)%、(493.66±47.79)m,均高于对照组[(34.02±8.06)%、(455.92±50.25)m],NT-proBNP水平为(4386.75±875.89)pg/mL,低于对照组[(4326.04±843.66)pg/mL],差异均有统计学意义(P<0.05)。治疗3个月后,观察组血清FGF-21水平为(54.93±12.51)pg/mL,低于对照组[(61.50±15.66)pg/mL],sVEGFR-2水平为(8.96±1.95)ng/mL,高于对照组[(8.14±1.67)ng/mL],差异均有统计学意义(P<0.05)。观察组与对照组MACE总发生率分别为6.00%、16.00%,差异无统计学意义(P>0.05)。结论在rhBNP治疗HFrEF的基础上加用恩格列净可明显提高临床疗效,改善患者心功能,降低HbA1c、FGF-21水平,并提高sVEGFR-2水平可能是其增效的作用机制。

rhBNP与沙库巴曲缬沙坦钠联合治疗对射血分数下降心力衰竭患者心功能及自主神经功能的影响

目的研究分析重组人脑利钠肽(Recombinant Human Brain Natriuretic Peptide,rhBNP)与沙库巴曲缬沙坦钠联合治疗对射血分数下降心力衰竭(Decreased Ejection Fraction Heart Failure,HFrEF)患者心功能及自主神经功能的影响。方法简单随机选取2022年8月—2023年8月漳州市第三医院收治的60例HFrEF患者作为研究对象,采用随机数表法分为两组,各30例。对照组予以沙库巴曲缬沙坦钠单药治疗,观察组予以rhBNP及沙库巴曲缬沙坦钠两药共治,比较两组患者的用药效果。结果观察组临床总有效率(93.33%)高于对照组(73.33%),差异有统计学意义(χ^(2)=4.320,P<0.05)。治疗后,观察组左室射血分数(Left Ventricular Ejection Fraction,LVEF)较对照组更高,左室舒张期后壁厚度(Left Ventricular Diastolic Posterior Wall Thickness,LVPWD)、左室舒张期内径(Left Ventricular Diastolic Diameter,LVEDD)均较对照组更低,差异有统计学意义(P均<0.05)。治疗后,观察组去甲肾上腺素(Norepinephrine,NE)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)及醛固酮水平均低于对照组,差异有统计学意义(P均<0.05)。两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论rhBNP与沙库巴曲缬沙坦钠两药共治可提升对HFrEF患者的治疗效果,有效改善其心功能及自主神经功能,且安全可靠。

rhBNP对心肌梗死后心肌细胞病理学和细胞凋亡的研究

目的:观察rhBNP对大鼠心肌梗死后心肌细胞病理学和细胞凋亡的影响。方法:建立大鼠心肌梗死模型,分为MI对照组和BNP治疗组。治疗组给予rhBNP连续静滴4周,治疗48 h、1、2、3和4周时处死大鼠,进行心肌组织切片HE染色,TUNEL法测心肌细胞凋亡指数MAI,免疫组化测Fas与FasL蛋白阳性染色指数。结果:治疗组MAI和Fas/Fasl蛋白阳性率与对照组比较下降有显著性差异(P<0.05)。结论:连续给予rhBNP能够通过减少MI后心肌细胞凋亡保护缺血心肌,达到改善心功能的目的。

rhBNP对急性前壁心肌梗死合并心力衰竭患者左心功能及远期左心室重构的影响

目的研究静脉应用重组人脑利钠肽(rhBNP)对经皮冠状动脉介入治疗(PCI)的急性心肌梗死合并心力衰竭患者左心功能和远期左心室重构的影响。方法将60例首发急性前壁ST段抬高心肌梗死合并急性心力衰竭患者随机分为rhBNP组和对照组,每组30例。比较2组患者治疗24 h的心功能改善情况、呼吸困难程度、整体临床状况、尿量的变化。监测2组治疗前及治疗后24 h、48 h血浆NT-proBNP水平,以及治疗前及治疗后肾素、血管紧张素Ⅱ、醛固酮水平。观察2组患者治疗后24 h、出院时及出院后6个月时心功能及左心室重构变化。结果用药后24 h rhBNP组患者呼吸困难程度、尿量、尿量与入量的差值、EF值、Tei指数与对照组比较,差异有统计学意义(P<0.05);与对照组相比,治疗48 h时,rhBNP组的血浆rhBNP、肾素、血管紧张素Ⅱ及醛固酮水平下降更明显(P<0.05);2组患者好转出院时,左心室舒张末期容积(LVEDV)差异无统计学意义(P>0.05),而rhBNP组EF值及Tei指数较对照组明显升高(P<0.05);出院后6个月时,rhBNP组Tei指数、EF值较对照组仍明显升高(P<0.05),而rhBNP组LVEDV及ΔLVEDV%较对照组降低(P<0.05)。结论 rhBNP能有效改善急性心肌梗死后心力衰竭患者的呼吸困难和临床状况,并且可以延缓远期心室重构,改善远期心功能。

短期rhBNP联合小剂量多巴酚丁胺治疗急性心肌梗死直接PCI术后泵衰竭的疗效观察

目的观察短期国产重组人脑利钠肽(rhBNP)联合小剂量多巴酚丁胺治疗急性心肌梗死致泵衰竭的疗效及安全性。方法将住院诊断为急性心肌梗死直接经皮冠状动脉介入术后泵衰竭患者83例分为两组。对照组在常规治疗基础上单用rhBNP,观察组在同一基础上用国产rhBNP联合小剂量多巴酚丁胺,两组均连用72 h,测定两组治疗前和停止用药8 h后血浆脑利钠肽(BNP)、有创动脉压、心率、左室射血分数、左室舒张内径、左房内径、肺动脉压、血肌酐、血钠等指标,比较两组治疗前后上述指标的变化。结果观察组治疗后与对照组患者在有创动脉压、左室射血分数、左室舒张内径、左房内径方面比较,差异均有显著性(P<0.01);肺动脉压、血浆BNP、血钾、血钠和心率差异无显著性(P>0.01);无增加心血管不良事件发生率,且住院时间减少,医疗费用降低。结论急性心肌梗死致泵衰竭短期使用rhBNP联合小剂量多巴酚丁胺治疗是有效、安全和经济的。

rhBNP对重症心脏瓣膜病术后血流动力学效应的影响

目的探讨重组人脑利钠肽(rhBNP)对重症心脏瓣膜病患者术后血流动力学效应及用药安全性。方法 38例入选的重症瓣膜病患者随机化分为rhBNP组(n=21)和对照组(n=17)。各组术前均经右侧颈内静脉置入Swan-Ganz导管进行血流动力学指标监测[肺毛细血管楔压(PCWP)、平均肺动脉压(mPAP)、心排指数(CI)]。术后监护室治疗方案:对照组予以常规强心扩血管药物治疗,rhBNP组给予rhBNP及强心药物治疗同时不再给予扩血管治疗。rhBNP给药方式:首先以1.5μg/kg负荷剂量冲击,再以0.0075μg/(kg·min)持续静脉滴注24 h。以rhBNP组静脉给药前及给药后0.5、1、3、6、12、24 h为时间节点,测定各组血流动力学指标。记录用药过程中所有不良事件,以评价药物安全性。结果 rhBNP组较对照组PCWP在给药后0.5、1、3、6 h时间节点有显著下降(P<0.05),mPAP在给药后各时间节点均有显著下降(P<0.05),而CI在给药后1、3、6 h时间节点显著上升(P<0.05)。在药物不良事件方面,两组差异无统计学意义。结论 rhBNP能明显改善重症心脏瓣膜病患者术后血流动力学效应,进而改善心脏功能,且用药安全性良好。

阿托伐他汀联合rhBNP治疗AMI合并心力衰竭的临床疗效

目的探讨阿托伐他汀联合重组人脑利钠肽(rhBNP)对急性心肌梗死(AMI)合并心力衰竭患者的临床疗效及对血清指标和心功能的影响。方法选取2014年12月至2016年5月该院收治的126例AMI合并心力衰竭患者作为研究对象,按照随机数字表法将患者分为研究组和对照组,每组63例。对照组使用氯吡格雷、肝素等药物治疗,并且进行吸氧、抗感染等对症治疗;研究组在对照组治疗方案的基础上使用阿托伐他汀联合rhBNP治疗,两组均治疗2周。比较两组患者治疗总有效率、治疗前后血清指标、血流动力学指标及心功能分级的差异。结果研究组治疗总有效率为81.0%,对照组为63.5%,研究组高于对照组,差异有统计学意义(P<0.05);治疗前,两组患者天门冬氨酸氨基转移酶、肌酸激酶、肌酸激酶同工酶和乳酸脱氢酶水平比较差异无统计学意义(P>0.05),治疗后,研究组以上血清各指标均高于对照组,差异有统计学意义(P<0.05);治疗前,两组间收缩压、呼吸频率、心率、血氧饱和度等比较差异均无统计学意义(P>0.05),治疗后,研究组收缩压、呼吸频率、心率均低于对照组,差异有统计学意义(P<0.05),研究组血氧饱和度高于对照组,组间比较差异无统计学意义(P>0.05);研究组心功能分级Ⅰ级和Ⅱ级例数所占比例高于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀联合rhBNP治疗AMI合并心力衰竭效果明显,能够有效纠正血清指标和血流动力参数,改善心功能,值得临床推广使用。

rhBNP对急性心肌梗死早期高危患者心功能及左室重塑的影响

目的研究重组人脑利钠肽（rh BNP）对急性心肌梗死早期高危患者早期心功能及左室重塑的影响。方法选取2013年1月至2014年09月山西医科大学附属汾阳医院心内科收治的首次急性心肌梗死（AMI）患者52例,男性28例,女性24例,年龄41~75岁,平均年龄（60.8±9.8）岁。所有患者随机分为rh BNP组（n=23）和对照组（n=29）。对照组仅给予常规治疗,rh BNP组在常规治疗的基础上静脉泵入rh BNP3~5 d。测定两组患者入院即刻、入院1周后N末端脑钠肽前体（NT-pro BNP）、左室射血分数（LVEF）、左室舒张末期内径（LVEDd）,记录1周后心功能Killip分级、心源性死亡。结果两组入院1周后临床心功能Killip分级情况以及心源性死亡比例比较,差异无统计学意义（P均〉0.05）。与治疗前比较,治疗后对照组NT-pro BNP水平升高,rh BNP组降低,差异有显著统计学意义（P均〈0.01）。两组治疗后较治疗前LVEF升高,LVEDd增加,差异有统计学意义（P均〈0.05）。与对照组治疗后比较,rh BNP组NT-pro BNP水平降低[（2204.94±830.90）pg/ml vs.（1498.29±707.33）pg/ml],LVEDd减少[（53.60±5.25）mm vs.（49.87±3.36）mm],差异有明显统计学意义（P均〈0.01）。结论 AMI早期高危患者及早应用rh BNP治疗可以有效改善心功能、抑制早期左室重塑。

rhBNP对内毒素介导的犬急性肾损伤的保护作用

目的：观察重组人脑利钠肽（recombinant human brain natriuretic peptide，rhBNP）对犬急性肾损伤的保护作用，探讨rhBNP对内毒素介导的犬急性肾损伤血清HMGB1水平的影响。方法20只健康成年犬随机均分为4组（n＝5）：空白对照组，脓毒症组、低剂量干预组和高剂量干预组。除空白组外的15只健康成年犬静脉注射脂多糖建立脓毒症休克模型。脓毒症组和空白组不给予rhBNP处理，低剂量干预组和高剂量干预组分别给予5μg/kg、10μg/kg rhBNP处理。观察各组犬于0、2、4、8、12 h时的外周血管阻力（systemic vascular resistance index，SVRI），并在以上各时间点留取适量外周静脉血用于检测血清高迁移率族蛋白-1（high mobility group box-1，HMGB-1）的水平和肌酐值（creatinine values，CR），于12 h后处死动物并留取肾脏标本用于组织病理学观察。结果①光镜下观察脓毒症组肾小管上皮细胞肿胀、出现管型，间质细胞肿胀，肾脏组织病理评分为3分；低剂量干预组与高剂量干预组上述改变明显减轻，但2者镜下观察差异不显著，肾脏组织病理评分均为1～2分。②与同时间点脓毒症组相比，低剂量干预组在8、12 h时血清CR水平显著降低（P＜0.01），高剂量干预组血清CR水平在4 h、8 h、12 h时显著降低（P＜0.01）；高剂量干预组与低剂量干预组相比，血清CR水平在4 h、8 h、12 h时均有显著性差异（P＜0.05）。③与同时间点脓毒症组比较，低剂量干预组在2 h时SVRI显著降低（P＜0.01），高剂量干预组在2 h、4 h时SVRI显著降低（P＜0.01）；高剂量干预组与低剂量干预组相比，SVRI于4 h时差异有统计学意义（P＜0.05）。④与同时间点脓毒症组相比，低剂量干预组与高剂量干预组犬血清HMGB-1水平均显著降低（P＜0.01）；高剂量干预组与同时间点低剂量干预组比较，血清HMGB-1水平显著性减少（P＜0.05）。结论 rhBNP可以有效减轻内毒素介导的犬肾组织损伤，改善肾功能，并降低SVRI，且其治疗作用呈剂量-效应关系；rhBNP还能有效降低脓毒症犬血清HMGB-1水平，可能与晚期炎症因子HMGB1水平的降低有关。

rhBNP在缺血性心脏病心力衰竭治疗中的临床观察

目的观察重组人脑利钠肽对缺血性心脏病所致心力衰竭的治疗作用。方法选取缺血性心脏病所致心力衰竭患者共计40例,随机分为研究组及对照组,每组患者各20例;给予两组患者标准化抗心衰治疗的同时分别静脉应用重组人脑利钠肽及硝普钠,观察两组患者治疗前后血浆BNP浓度、左室射血分数、心率变异性、呼吸困难缓解程度及客观体征改善程度的变化。结果研究组治疗前后血浆BNP浓度、左室射血分数、心率变异性、呼吸困难缓解程度及客观体征改善程度明显优于对照组,差异具有统计学意义(P<0.05)。结论重组人脑利钠肽可以有效减轻缺血性心脏病心力衰竭患者呼吸困难程度、降低血浆BNP、提高心率变异性及射血分数。

重组人脑钠肽(rhBNP)对兔血流动力学和电生理的影响

目的:观察短期静脉滴注重组人脑钠肽(rhBNP)对家兔的血流动力学和组织电生理作用的影响.方法:健康家兔12只,以0.09μg/(kg·min)静脉滴注rhBNP,应用单相动作电位记录技术,同步记录用药前后心外膜、中层及心内膜心肌单相动作电位(MAP)及体表心电图,分析相关参数的变化;颈总动脉插管,记录动脉血压曲线、左心室内压力曲线变化.结果:用药前后,血流动力学指标动脉收缩压(SAP),舒张压(DAP)和平均动脉压(MAP)下降;左室舒张末压(LVEDP),左室收缩压(LVSP)下降(P<0.05).左室内压最大上升、下降速率(±dp/dt)max用药前后比较无显著差异.电生理指标3层心肌单相动作电位时程,体表心电图指标无显著差异.结论:在健康家兔,短期静脉滴注重组人脑钠肽对电生理指标没有影响,可改变血流动力学指标.

rhBNP治疗急性心肌梗死伴急性左心衰竭的临床观察

目的:探讨重组人脑利钠肽(rhBNP)在急性心肌梗死(AMI)伴急性左心衰竭(ALHF)治疗中的临床疗效以及可能存在的不良反应。方法:将52例AMI伴ALHF的患者依据治疗方式分为rhBNP组(治疗组)30例和硝酸甘油组(对照组)22例,观察所有患者在治疗后的临床症状和体征改善情况,记录治疗前后的收缩压(SBP)、心率(HR)、尿量(UV)、脑利钠肽(BNP)水平、血肌酐(Cr)水平及住院时间等指标。结果:治疗组在治疗后UV和BNP水平较对照组均有明显改善,差异有统计学意义(P<0.01),而治疗后2组在HR、SBP、Cr水平方面差异无统计学意义(P>0.05)。治疗组的临床疗效优于对照组。结论:rhBNP在临床治疗AMI合并ALHF方面安全有效。

rhBNP治疗高龄女性急性非ST抬高性心肌梗死临床观察

目的:探讨冻干重组人脑利钠肽(新活素,rh BNP)治疗高龄女性非ST抬高急性心肌梗死(NSTEMI)的有效性。方法:96例NSTEMI女性患者,随机分为rh BNP组和RT组(常规治疗组),rh BNP组在常规治疗基础上加用rh BNP治疗,观察两组尿量、CTNI恢复时间、住院天数、恶性心律失常发生率、死亡率、肾功能变化等。结果:rh BNP组患者比RT组治疗后尿量明显增加,差异有统计学意义[日均尿量(1315±355)ml比(2014±518)ml,P<0.01]。rh BNP组CTNI恢复时间和住院时间均短于RT组,差异有统计学意义[CTNI恢复时间(6.7±2.7)比(4.4±1.3)天,住院时间(25.6±7.8)比(20.9±6.5)天,P<0.01];两组肾功能情况治疗前后对比无统计学差异;两组恶性心律失常及死亡率方面无统计学差异。结论:高龄女性NSTEMI患者rh BNP虽不能改善住院期间死亡率,但能更好的缓解症状,缩短治疗时间,减少住院费用,是急诊PCI治疗的有效补充。