| Objective：To investigate the influence of recombinant human brain natriuretic peptideupon RASS system、EPCs、inflammation cytokine and the cardiac function in treatingpatients with decompensated acute heart failure (ADHF).MEthods：A total of46patients characterized of decompensated acute heart failurewere enrolled in this randomized, open-label, parallel-design study. All patients withADHF were randomly divided into rhBNP group (n=23) and NIT group (n=23),Standard treatment of heart failure were given to the patients of both groups, rhBNP(2.0μg/kg bolus intravenous injection followed by0.01μg·kg-1·min-1for24hours) wasgiven to patients in rhBNP group, NIT (starting at10μg/min and increasing5μg/mineach time till clinical effective dose for24hours) was given to patients in NIT group.Plasma renin activity (PRA)、angiotensin II(Ang1I)、aldosterone(ALD)、endothelialprogenitor cells (EPCs)、tumor necrosis factor-α (TNF-α)、interleukins-1β(IL-1β)、 Inteleukin-6(IL-6)、 brain natriuretic peptide(BNP)、 left ventricularend-systolic diameter (LVESD)、left ventricular end-diastotic diameter(LVDD) and leftventricular ejection fraction(LVEF)were compared between the two groups．Results：1）In rhBNP group, there were statistically significant reductions in plasmaconcentration levels of renin, angiotensin II and aldosterone after administration ofrhBNP (all P <0.01).The reductions of all these neurohormones in NIT group also hadstatistical significance (all P <0.05). But compared with those in rhBNP group the levelsof neurohormones in NIT group were still higher (all P<0.05).At24h after discontinuing infusion of NIT, There were no significant differences in plasma levels of renin,angiotensin II and aldosterone at that time compared with baseline in NIT group(all P＞0.05).In contrast, all above plasma neurohormonal concentration were significantlylower at24h after discontinuing infusion compare to those at baseline in rhBNPgroup(all P <0.01),as well as there were significant reduction compared with those inNIT group(all P <0.05).2）In rhBNP group, there was statistically significant increase in the numberof circulating EPCs after administration of rhBNP (P <0.01). The increase of circulatingEPCs in NIT group also had statistical significance (P <0.05). But compared with that inrhBNP group the number of circulating EPCs in NIT group were still lower (P <0.05).At24h after discontinuing infusion of NIT, There was no significant difference in thenumber of circulating EPCs at that time compared with baseline in NIT group(P＞0.05).In contrast, the number of circulating EPCs was significantly higher at24h afterdiscontinuing infusion compare to that at baseline in rhBNP group(P <0.01),as well asthere was significant increase compared with that in NIT group(P <0.01).3）In both groups, there were statistically significant reductions in plasmaconcentration levels of tumor necrosis factor-α, interleukins-1βandInteleukin-6aftertreatment1week (all P <0.05). The levels of plasma IL-6in rhBNP group wassignificantly lower compare to with that in NIT group(P <0.05).But there were nosignificant differences in plasma levels of TNF-α、IL-1β between two groups aftertreatment1week (all P＞0.05).4）In both groups, there were statistically significant reductions in plasmaconcentration levels of brain natriuretic peptide after treatment1week (all P <0.01).The levels of plasma BNP in NIT group was significantly higher compare to with that inrhBNP group (P <0.05).The heart function,including LVEF、LVESD,were improvedsignificantly after treatment1week (all P <0.05).The improvement in the rhBNP groupwere much more marked as compared those in NIT group(all P <0.05),But the LVDD in both groups has no significant difference after treatment1week(P＞0.05).Conclusions：In patients with ADHF, rhBNP,Compared with NIT,can inhibit plasmaPRA, Ang1I, ALD speedily and effciently、improve EPCs in the circulation and thecardiac functions effectively. It aslo has a certain degree of advantage in inhibitionof inflammation. |
PDF Full Text Request