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目的探讨重组人脑利钠肽(rhBNP)对慢性心力衰竭患者血清N-末端B型钠尿肽前体(NT-proBNP)及白介素-6(IL-6)水平的影响。方法将106例慢性心力衰竭患者随机分为对照组和观察组,每组53例。所有患者应用强心剂、利尿剂、β-受体阻滞剂、血管紧张素转换酶抑制剂等常规抗心力衰竭治疗,对合并肺内感染的患者给予抗生素治疗。观察组在常规抗心力衰竭治疗基础上应用rhBNP治疗;对照组在常规抗心力衰竭治疗基础上应用多巴酚丁胺治疗。两组入院后当天进行NYHA分级,并记录年龄、性别和原发病情况。测量两组治疗前后心率、收缩压、舒张压、电解质浓度、左心室射血分数等。检测两组治疗前后血清NT-proBNP及IL-6浓度。结果与治疗前比较,两组患者左心室射血分数均有明显改善(P<0.05),且观察组提高幅度更大,明显高于对照组(P<0.05)。两组血清NT-proBNP及IL-6水平均较治疗前明显下降(P<0.05),且观察组较对照组下降程度更为显著(P<0.05)。结论 rhBNP治疗慢性心力衰竭的疗效明显,其作用机制可能与拮抗IL-6等炎症因子的过度激活有关。
Objective To investigate the effect of recombinant human brain natriuretic peptide (rhBNP) on the levels of serum NT-proBNP and IL-6 in patients with chronic heart failure. Methods 106 patients with chronic heart failure were randomly divided into control group and observation group, with 53 cases in each group. All patients were treated with conventional anti-heart failure, such as cardiotonics, diuretics, β-blockers and angiotensin converting enzyme inhibitors, and antibiotics were given to patients with pulmonary infection. The observation group was treated with rhBNP on the basis of routine anti-heart failure treatment, while the control group was given dobutamine on the basis of conventional anti-heart failure treatment. The NYHA classification was performed on the day after admission, and the age, sex, and primary disease were recorded. Heart rate, systolic blood pressure, diastolic blood pressure, electrolyte concentration, left ventricular ejection fraction and so on were measured before and after treatment. Serum NT-proBNP and IL-6 levels were measured before and after treatment in both groups. Results Compared with before treatment, left ventricular ejection fraction of both groups were significantly improved (P <0.05), and the observation group increased more significantly than the control group (P <0.05). Serum levels of NT-proBNP and IL-6 in both groups were significantly lower than those before treatment (P <0.05), and the degree of decline in the observation group was more significant than that in the control group (P <0.05). Conclusion rhBNP treatment of chronic heart failure has obvious curative effect, and its mechanism may be related to antagonizing the excessive activation of IL-6 and other inflammatory factors.