重组人脑钠肽对心衰患者心室重构的影响及机制
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[摘要] 目的 研究重组人脑钠肽(rhBNP)对心衰患者心室重构的影响，并探讨其可能机制。方法 50例心衰患者随机分为rhBNP治疗组与对照组，每组25例，随访3个月，治疗前后分别测定LVEDD、EF及血清Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、透明质酸(HA)和一氧化氮(NO)水平，并进行比较。结果 rhBNP治疗3个月后，血清PCⅢ、CⅣ和HA水平较治疗前显著降低[(100.8±10.5)μg/L vs (156.1±10.2)μg/L；(75.0±9.5)mg/L vs (105.7±11.0)mg/L；(85.2±9.3)mg/L vs (122.5±10.6)mg/L；P均<0.05]，NO水平较治疗前显著增加[(92.20±9.6)μmol/L vs (76.82±10.1)μmol/L，P<0.05]，对照组各指标无明显改变(P均>0.05)。结论 rhBNP治疗能改善心衰症状，减轻心室重构，其机制可能与降低血清中胶原水平、增加NO浓度有关。
[关键词] 脑钠肽；心衰；胶原；透明质酸；一氧化氮
[中图分类号] R541.6 [文献标识码] B [文章编号] 1673-9701(2011)21-80-02
The Effects and Mechanisms of rhBNP on the Vantricular Remodeling in Patients with Heart Failure
DU SongLUO PingWANG ShunbaoWANG Liuyi
Department of Cardiology，Henan Province People’s Hospital，Zhengzhou 450003，China
[Abstract] Objective To evaluate the effects and mechanisms of rhBNP on the vantricular remodeling in patients with heart failure. Methods Fifty patients with heart failure were selected and divided randomly into two groups：rhBNP treatment group and control group，each group had twenty-five patients. They were followed up for three months. The LVEDD and the concentrations of serum PCⅢ， CⅣ，HA and NO were measured before treatment and after three months treatment，then compared between two groups. Results After three months treatment，the concentrations of serum PCⅢ，CⅣ and HA decreased in rhBNP treatment group (100.8±10.5)μg/L vs (156.1±10.2)μg/L；(75.0±9.5)mg/L vs (105.7±11.0)mg/L；(85.2±9.3)mg/L vs (122.5±10.6)mg/L；all P<0.05；the levels of NO increased (92.20±9.6)μmol/L vs (76.82±10.1)μmol/L，P<0.05，while after three months followup，there were not significant differences of all observed indicators in control group(all P>0.05). Conclusion After rhBNP treatment，the serum levels of PCⅢ，CⅣ and HA decreased and the levels of serum NO increased，which contributed to the improvement of the vantricular remodeling.
[Key words] BNP；Heart failure；Collagen；Hyaluronic acid；Natric oxide
心力衰竭(心衰)是各种心脏病发展到晚期的共同表现，是严重危害人民健康的疾病之一。近些年，心衰的研究取得了较大的进步[1-4] ......
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