重组人脑利钠肽治疗慢性心力衰竭对白细胞介素-6水平的影响

目的:评价重组人脑利钠肽(rhBNP)治疗慢性心力衰竭的疗效及对血浆白细胞介素(IL)-6水平的影响。方法:对30例入选患者进行随机、开放、对照临床试验。其中干预组15例,给予rhBNP治疗;对照组15例,给予硝酸甘油治疗,观察两组用药前后心功能及血流动力学指标及5d后血浆IL-6水平的变化,以探讨应用rhBNP治疗慢性心力衰竭的疗效及作用机制。结果:在血流动力学上,rhBNP干预组在用药后明显改善心功能(P<0.05),但对心率(HR)、血压(BP)、电解质等指标无影响;硝酸甘油对照组用药后也能明显改善心功能(P<0.05)。rhBNP干预组与对照组相比,在降低患者血浆IL-6方面有统计学差异(P<0.05)。结论:rhBNP可以显著降低慢性心衰患者IL-6浓度,机制可能与其扩张全身动静脉,降低心肌氧耗以及扩张冠状动脉,增加心肌供血供氧,改善心肌缺血情况下炎性细胞因子释放有关。

Effects of Recombinant Human Brain Peptide on Serum IL-6 Levels in Heart Failure Patients

Objective:To evaluate the effects of the recombination human brain natriuretic peptide(rhBNP)on the serum interleukin-6(IL-6)in patients who had diagnosed chronic heart failure. Methods:Thirty patients were randomly divided into treatment group(n=15)and control group(n=15).The treatment group was treated with rhBNP while the control group was treated with nitroglycerin.The serum levels of IL-6were measured on the day before treatment,24hours and 72hours after treatment respectively.The blood rheologic indexes and cardiac function were compared before and after treatment.Results:The cardiac function in treatment group were significantly improved(P<0.05),but the other indexes such as heart rate(HR),blood pressure(BP),and plasma electrolytes were not affected.Compared with that in control group,the plasma levels of IL-6in treatment group were significantly lower after treatment(P <0.05). Conclusion:The rhBNP not only reduces the levels of serum IL-6but also improves the cardiac function of the patients with heart failure.The rhBNP may reduce the myocardial oxygen consumption,outspread heart coronary artery,enhance oxygen supply to myocardium,and alleviate inflammatory reaction under the condition of myocardial ischemia.