重组人脑利钠肽联合呋塞米对急性心肌梗死患者血清MMP-2、GDF-15、CYR61水平的影响

目的观察重组人脑利钠肽(rhBNP)联合呋塞米对急性心肌梗死患者的治疗效果及对血清基质金属蛋白酶2(MMP-2)、生长分化因子15(GDF-15)、富含半胱氨酸蛋白61(CYR61)水平的影响。方法选取2018年11月—2019年11月湖南省人民医院/湖南师范大学附属第一医院心内科收治急性心肌梗死患者105例,随机数字表法分为呋塞米组52例、联合组53例,2组患者均给予常规治疗,呋塞米组加用呋塞米治疗,联合组加用呋塞米及rhBNP,治疗5 d后,比较2组患者治疗效果,治疗前后心功能、血清T淋巴细胞亚群水平、肌钙蛋白I(cTnI)、高敏肌钙蛋白I(hs-TNI)、高敏C反应蛋白(hs-CRP)、白介素-8(IL-8)、IL-17、MMP-2、GDF-15、CYR61水平。结果联合组患者治疗总有效率高于呋塞米组(88.68%vs.73.08%,χ~2/P=4.144/0.042)。治疗后联合组心排出量(CO)、LVEF、CD4~+、CD3~+水平高于呋塞米组(t/P=2.883/0.005、3.560/0.001、5.634/0.001、4.720/0.001),LVPWd、CD8~+、cTnI、hs-TNI、hs-CRP、IL-8、IL-17、MMP-2、GDF-15、CYR61水平低于呋塞米组(t/P=5.032/0.001、5.822/0.001、11.320/0.001、3.559/0.001、9.660/0.001、3.472/0.001、8.862/0.001、6.978/0.001、17.440/0.001、6.085/0.001)。结论 rhBNP联合呋塞米治疗急性心肌梗死具有一定疗效,能够改善患者心功能,减轻心肌损伤、炎性反应,提升患者免疫功能,调控血清MMP-2、GDF-15、CYR61水平,治疗效果显著。

Effect of recombinant human brain natriuretic peptide combined with furosemide on serum MMP-2,GDF-15,CYR61 levels in patients with acute myocardial infarction

Objective To observe the therapeutic effect of recombinant human brain natriuretic peptide(rhBNP)combined with furosemide on patients with acute myocardial infarction and on serum matrix metalloproteinase 2(MMP-2),growth differentiation factor 15(GDF-15),and cysteine-rich protein 61(CYR61)level.Methods From November 2018 to November 2019,105 patients with acute myocardial infarction were admitted to the Department of Cardiology,Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University.Random number table method was divided into 52 cases in furosemide group and 53 cases in combined group.Both groups were given conventional treatment,the furosemide group was treated with furosemide,and the combination group was treated with furosemide and rhBNP.After 5 days of treatment,the treatment effects of the 2 groups were compared,and the cardiac function and serum T lymphocytes,troponin I(cTnI),high-sensitivity troponin I(hs-TNI),high-sensitivity C-reactive protein(hs-CRP),interleukin 8(IL-8),IL-17,MMP-2,GDF-15,CYR61 levels were compared before and after treatment.Results The total effective rate of treatment in the combined group was higher than that in the furosemide group(88.68%vs.73.08%,χ2/P=4.144/0.042).After treatment,the combined group CO,LVEF,CD4+,CD3+levels were higher than the furosemide group(t/P=2.883/0.005,3.560/0.001,5.634/0.001,4.720/0.001),LVPWd,CD8+,cTnI,hs-TNI,hs-CRP,IL-8,IL-17,MMP-2,GDF-15,and CYR61 were lower than the furosemide group(t/P=5.032/0.001,5.822/0.001,11.320/0.001,3.559/0.001,9.660/0.001,3.472/0.001,8.862/0.001,6.978/0.001,17.440/0.001,6.085/0.001).Conclusion rhBNP combined with furosemide has a certain curative effect in the treatment of acute myocardial infarction,which can improve the heart function of patients,reduce myocardial injury and inflammatory response,enhance the immune function of patients,and regulate serum MMP-2,GDF-15,CYR61 levels,and the treatment effect is significant.