丹红注射液对急性心肌梗死PCI围手术期心功能和TIMI血流影响的Meta分析

目的:系统评价丹红注射液对急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)围手术期心功能和心肌梗塞溶栓治疗(TIMI)血流分级的影响。方法:计算机检索CNKI,万方数据库,维普数据库,Pub Med,CBM,Web of Science,The Cochrane Library共7个数据库,全面采集在PCI围手术期应用丹红注射液治疗急性心梗的临床试验,采用Cochrane风险评价表进行文献质量评价,运用Revman 5.3软件进行Meta分析。结果:共纳入12个临床试验,包含1131例患者,其中丹红治疗组569例,对照组562例,结果显示在常规治疗的基础上加入丹红注射液治疗,患者的左室射血分数明显增高[均数差(MD)=6.62,95%可信区间(CI)(4.91,8.34),P<0.00001],TIMI分级3级患者明显增多[相对危险度(RR)=0.22,95%CI(0.12,0.41),P<0.00001],脑利钠肽水平明显降低[MD=-151.86,95%CI(-247.00,-56.72),P=0.002]。结论:丹红注射液可以提高急性心梗PCI围手术期心功能和增加TIMI血流的分级。     

肾动脉狭窄介入治疗前后血清脑利钠肽水平的变化及意义的研究

目的探讨肾动脉狭窄介入治疗前后血清脑利钠肽BNP水平的变化及意义。方法采用回顾性调查方法，对肾动脉狭窄介入治疗前后血清脑利钠肽水平的变化进行分析。结果肾动脉狭窄介入治疗再通后，血清BNP水平出现下降（P〈0．01）。结论血清BNP水平的变化对肾动脉狭窄介入治疗后疗效的评价具有一定的临床指导意义。     

Vasodilator effects of C-type natriuretic peptide on cerebral arterioles in rats

The vasodilator effects of C-type natriuretic peptide (CNP) were investigated in isolated rat cerebral arterioles. CNP caused dose-dependent vasodilation, maximally by 10.0±2.2% at 10⁻⁶ M. The median effective concentration (EC₅₀) was 5.2×10⁻¹⁰ M. In contrast, atrial natriuretic peptide and B-type natriuretic peptide, other members of the natriuretic peptide family, produced little or no vasodilation. Pretreatment with methylene blue (10⁻⁴ M) abolished CNP-induced vasodilation, whereas pretreatment with N^G-monomethyl-

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-arginine or indomethacin did not inhibit vasodilation. Thus, CNP is suggested to cause significant vasodilation in cerebral arterioles via a cyclic guanosine monophosphate-dependent mechanism. © 1997 Elsevier Science B.V. All rights reserved.     

中枢和外周脑钠素(BNP)调节醛固酮分泌的不同作用

将BNP和AT-Ⅱ、ACTH AVP单独或BNP与这3种肽分别合并在大鼠icv或iv注入后观察血Ald浓度的变化。实验结果表明:①iv给予AVP(5μg/3ml·h~(-1))、ACTH(5μg/3ml·h~(-1))和AT-Ⅱ(5 v.g/3 ml·h(-1)),1h后均能增加血Ald的浓度。iv给予BNP(5μg/3ml·h(-1))能明显抑制AVP和ACTH的刺激作用,而不影响AT-Ⅱ的刺激作用。②icv给予BNP(2 Vg/10 pl NS)能降低血Aid浓度。icv给予AVP(2μg/10μl NS)能增加血Aid浓度,但ACTH(2μg/10μl NS)和AT-Ⅱ(2μg/10μl NS)无此种作用。但如脑室同时给予BNP(2μg/10μlNS)却可明显刺激Aid分泌。③icv注入BNP对外周注入的3种多肽的刺激作用无任何影响。从上述的实验结果可看出:脑内BNP可“反常”地增加AT-Ⅱ、ACTH和AVP对Ald分泌的刺激作用,与外周抑制AVP,ACTH的刺激作用不同。而脑内BNP不影响这3种多肽的外周刺激作用。结论是脑内BNP以其独特的方式调节Ald的分泌,控制水盐代谢。     

Atrial amyloid deposits in the failing human heart display both atrial and brain natriuretic peptide-like immunoreactivity

Atrial amyloid deposits are common in the ageing human heart and contain alpha-atrial natriuretic peptide (proANP99-126) immunoreactivity. However, atrial myocytes secrete both amino and carboxy terminal fragments of the ANP prohormone (proANP1-126) and also express an homologous, but separate brain natriuretic peptide (BNP). Characteristic amyloid deposits were identified in the atria of 9/22 patients (26-63 years of age) with end-stage heart failure. Amyloid fibrils displayed immunoreactivity for both amino and carboxy terminal fragments of proANP1-126 and for the distinct BNP sequence. As in other endocrine organs, both mature and precursor peptide sequences appear to be constituents of amyloid fibrils. Whilst immunoreactivity for cardiac peptide hormones is co-localized in atrial amyloid deposits, it is uncertain whether the increase in natriuretic peptide expression which accompanies cardiac failure contributes to the incidence of isolated atrial amyloidosis.     

左心功能不全患者超声参数与血浆NT-proBNP的关系

目的:观察血浆N末端脑尿钠肽(NT-proBNP)浓度与心功能分级、左室射血分数、组织多普勒(DTI)等指标之间的关系.方法:对55例冠心病患者、32例正常人测定血浆NT-proBNP浓度、LVEF、DTI等指标.结果:心衰组NT-proBNP中位数显著高于对照组.NYHA分级与NT-proBNP、左房径、左室径、E/e呈正相关;与LVEF、Vs、Ve、Va、VTIs、VTIe、VTIa呈负相关.心力衰竭组血浆NT-proBNP水平与左房径,左室径、E/e呈正相关;与LVEF、Vs、Ve、Va、VTIs、VTIe、VTIa呈负相关性.结论:LVEF和DTI所测出的多项参数能较客观的反映心脏功能,与NT-proBNP所反映出的心脏功能变化有着很好的相关性.     

老年难治性心力衰竭患者BNP、hs-CRP水平与心功能的相关性及其临床意义

【摘要】目的：探究老年难治性心力衰竭（心衰）患者BNP、hs-CRP水平与心功能的相关性及其临床意义。方法：以我院心内科近两年收治的61例老年难治性心衰患者为临床研究对象，作为心衰组，另选20例健康志愿者作为对照组。心衰组患者按照NYHA分级的不同，从低到高分成A、B、C三组。对患者进行BNP与hs-CRP测定，并测定患者的心功能LVDD和LVEF。跟踪记录患者的心血管事件发生情况，比较患者BNP、hs-CRP、LVEF、LVDD水平的差异。结果：与对照组相比，心衰组患者的LVDD、BNP与hs-CRP指标显著较高而LVEF指标显著较低；A、B、C三组患者的LVDD、BNP与hs-CRP指标逐渐升高、LVEF水平逐渐下降；与无心血管事件患者相比，出现心血管事件患者的BNP、hs-CRP、LVDD水平显著较高，LVEF指标则显著低。差异均具有统计学意义（P＜0.05）。结论：BNP与hs-CRP指标与老年难治性患者的心功能具有密切的关系，BNP、hs-CRP以及患者的LVEF、LVDD水平是临床诊断老年难治性心衰的重要标志物，具有重要的临床诊断价值。