目的 探讨重组人脑利钠肽(rhBNP)对慢性心力衰竭患者血浆可溶性晚期糖基化终末产物受体(sRAGE)、核转录因子-κB(NF-κB)及心功能的影响.方法 选取2014年1月～2016年2月于解放军总医院第一附属医院住院治疗的86例慢性心力衰竭患者,按照随机数字表法分为对照组(n=43)和rhBNP组(n=43).对照组给予硝酸甘油治疗,rhBNP组在对照组基础上加用rhBNP治疗.观察两组的临床疗效及不良反应,采用酶联免疫吸附法检测血浆sRAGE、NF-κB水平,分析两组患者治疗前后心功能及血浆sRAGE、NF-κB水平.结果 rhBNP组总有效率(83.7％)显著高于对照组(65.1％)(P＜0.05).两组治疗后左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室内径(LADD)明显低于治疗前(P＜0.01),心指数(CI)、左室射血分数(LVEF)明显高于治疗前(P＜0.05或P＜ 0.01).与对照组治疗后比较,rhBNP组各心功能指标改善更明显(P＜ 0.05或P＜ 0.01).两组治疗后血浆sRAGE、NF-κB较治疗前降低(P＜ 0.05或P＜ 0.01);与对照组治疗后比较,rhBNP组血浆sRAGE、NF-κB水平改善更明显(P＜ 0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 rhBNP治疗可有效改善心功能,降低慢性心力衰竭患者血浆sRAGE、NF-κB水平.%Objective To investigate the influence of recombinant human brain sodium peptide (rhBNP) on plasma soluble receptor for advanced glycation endproducts (sRAGE),nuclear factor-κB (NF-κB) and heart function in patients with chronic heart failure.Methods 86 patients with chronic heart failure from January 2014 to February 2016 in the First Affiliated Hospital of General Hospital of PLA were enrolled and randomly divided into control group (n=43) and rhBNP group (n=43).Nitroglycerin was used in control group,rhBNP was applied in rhBNP group on the basis of control group.Clinical effects and adverse drug reactions were observed in two groups.The levels of plasma sRAGE and NF-κB were measured by ELISA.The cardiac function and plasma sRAGE,NF-κB levels before and after treatment in two groups were analyzed.Results Total effective rate in rhBNP group (83.7％) was higher than that in control group (65.1％) (P ＜ 0.05).After treatment,LVESD,LVEDD and LADD in two groups were significantly lower than before treatment (P ＜ 0.01),CI and LVEF in two groups were significantly higher than before treatment (P ＜ 0.05 or P ＜0.01).Compared with control group after treatment,improvement of cardiac function index in rhBNP group was more obvious (P ＜ 0.05 or P ＜ 0.01).After treatment,the levels of plasma sRAGE and NF-κB in two groups were significantly lower than before treatment (P ＜ 0.05 or P ＜ 0.01).Compared with control group after treatment,improvement of plasma sRAGE and NF-κB in rhBNP group were more obvious (P ＜ 0.05).There was no significant difference in incidence rate of adverse reaction between two groups (P ＞ 0.05).Conclusion rhBNP may improve cardiac function,and reduce the levels of plasma sRAGE and NF-κB in the patients with chronic heart failure.
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