低剂量重组人脑利钠肽对老年急性非ST段抬高型心肌梗死患者心功能及炎症因子的影响

目的 观察低剂量重组人脑利钠肽（recombinant human brain natriuretic peptide,rhBNP）对老年急性非ST段抬高型心肌梗死患者心功能及炎症因子的影响.方法 选择老年急性非ST段抬高型心肌梗死致心力衰竭患者60例,分成rhBNP组和硝酸甘油组;两组均测定治疗前、后血浆中脑钠肽（brain natriuretic peptide,BNP）浓度及血清炎症因子高敏C反应蛋白（high-sensitivity C-reactive protein,hs-CRP）、金属基质蛋白酶（metal matrix protein,MMP-9）、白细胞介素-6（interleukin-6,IL-6）浓度,采用超声心动图检测左心室射血分数（left ventricular ejection fraction,LVEF）;并比较两组治疗前后上述指标的变化.结果 治疗后两组血浆rhBNP及炎症因子hs-CRP、MMP-9、IL-6的表达均显著降低,差异有统计学意义（P＜0.05）;LVEF均显著升高,差异有统计学意义（P＜0.05）,且以rhBNP治疗组变化更为显著.结论 低剂量rhBNP治疗老年急性非ST段抬高型心肌梗死能显著的改善心功能,降低炎症因子水平;有助于改善心肌梗死后心力衰竭的炎症应激状态.

Effects of low dose recombinant human brain natriuretic peptide on cardiac function and inflammatory factors in elderly patients with acute non-ST-elevation myocardial infarction

Objectives To evaluate the effects of recombinant human brain natriuretic peptide （rhBNP） on cardiac function and inflammatory factors in elderly patients with acute heart failure caused by acute non-ST-elevation myocardial infarction. Methods Totally 60 cases with acute heart failure caused by non-ST-elevation myocardial infarction admitted to hospital were randomly divided into two groups： treatment group （n=30） and control group （n=30）. Treatment group was treated with rhBNP based on conventional therapy in coronary heart disease and acute heart failure. Concentration of plasma brain natriuretic peptide （BNP） and serum concentrations of high-sensitivity C-reactive protein （hs-CRP）, metal matrix protein （MMP-9）, interleukin-6 （IL-6） before and after intravenous infusion of rhBNP were measured. Left ventricle ejection fraction （LVEF） was measured by echocardiography. Results After intravenous infusion of rhBNP, plasma concentration of BNP and serum concentrations of hs-CRP, MMP-9 and IL-6 of the patients significantly decreased, and LVEF elevated respectively compared with the situation before treatment （all P〈0.05）. Further more, the improvements in rhBNP treatment group were more obvious. Conclusions Intravenous infusion of low dose rhBNP in elderly patients with acute heart failure caused by non-ST-elevation myocardial infarction can reduce the levels of inflammatory factors and improve cardiac function, which can improve the inflammatory stringent state of heart failure caused by myocardial infarction.