重组人脑钠肽对射血分数正常心力衰竭患者脑钠肽前体的影响

目的探讨经重组人脑钠肽(recombinant human brain natriuretic peptide,rhBNP)治疗后,射血分数正常心力衰竭(heart failure with normal ejection fraction,HFNEF)患者的血浆脑钠肽前体(pro-brain natriuretic peptide,proBNP)浓度及临床症状的变化。方法入选51例HFNEF患者(纽约心脏协会心功能Ⅲ、Ⅳ级),其中21例在常规治疗的基础上加用rhBNP治疗4～7 d,治疗前、后分别检测血浆proBNP浓度,并与仅用常规治疗的对照组(30例)比较。分析治疗前、后血浆proBNP浓度及临床症状变化。结果治疗组与对照组总有效率分别为95.2%和93.3%,差异无统计学意义(P>0.05)。两组治疗后血浆proBNP浓度与治疗前比较都有下降,差异有统计学意义(P<0.05);且治疗组治疗后血浆proBNP浓度显著低于与对照组,差异有统计学意义1 297.5 pg/mL vs.2 037.8 pg/mL,P<0.05]。结论rhBNP可降低HFNEF患者血浆proBNP浓度,有效改善患者症状。

Effect of recombinant human brain natriuretic peptide on pro-brain natriuretic peptide in patients with chronic heart failure with normal ejection fraction

Objectives To assess the changes of plasma levels of pro-brain natriuretic peptide （proBNP） in patients with chronic heart failure with normal ejection fraction （HFNEF） after recombinant human brain natrinretic peptide （rhBNP） treatment. Methods Fitty-ong patients with HFNEF （New York heart association functional classification Ⅲ/Ⅳ ） were divided into control group （n=30, treated with routine therapy） and treatment group （n=21, treated with rhBNP for 4-7 days in addition to routine therapy）. After 1 week, changes of proBNP concentrations and clinical symptoms were observed and compared between the two groups. Results After 4-7 days＇ treatment, effective rate was 95.2% in treatment group and 93.3% in control group, but the difference between them was insignificant （P〉O.05）. Plasma concentrations of proBNP in both control group and treatment group decreased after treatment （P〈0.05） ; while plasma concentrations of proBNP in treatment group were significantly lower than those in control group 1 297.5 pg/mL vs. 2 037.8 pg/mL, P〈 0.05 ]. Conclusions Plasma concentrations of proBNP in patients with HFNEF decrease after treatment with rhBNP and symptoms of the patients can be improved.