重组人脑钠肽对心衰患者心室重构的影响及机制

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（PC11I）、1V型胶原（C1V）、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／LVS（156．1±10．2）μg／L；（75．0±9．5）mg／LVS（105．7±11．0）mg／L；（85．2±9．3）mg／LVS（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）pmol／Lvs（76．82±10．1）μmol／L，P〈0．051，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。

The Effects and Mechanisms of rhBNP on the Vantricular Remodeling in Patients with Heart Failure

Objective Toevaluate 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 PC m, c IV, 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 PC III, C IV 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 ） μ mol/L vs （ 76.82 ± 10.1 ） μ mol/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 rbBNP treatment, the serum levels of PC III, C IV and HA decreased and the levels of serum NO increased, which contributed to the improvement of the vantricular remodeling.