慢性心力衰竭患者B型利钠肽、C反应蛋白浓度变化的临床意义及丹参酮ⅡA磺酸钠注射液的治疗作用

目的:观察慢性心力衰竭患者外周血B型利钠肽(BNP)、C反应蛋白(CRP)浓度的变化,探讨丹参酮ⅡA磺酸钠注射液增加心肌供血,改善心功能的机制.方法:采用美国BIOSITE公司的trige分析仪检测外周血BNP的浓度,免疫浊度法测定CRP的浓度,研究正常对照组(20人),心脏病心功能正常组(33人),慢性心力衰竭组(61人)BNP、CRP浓度变化与慢性心衰患者心功能的相关性.并将CHF患者分为治疗组(33人)和对照组(28人),两组在同等的抗心衰治疗基础上,治疗组加用丹参酮ⅡA磺酸钠注射液60毫克,1个疗程(15天)结束后评定治疗前后两组的疗效及血浆BNP、CRP水平的变化.结果:与正常对照组和心脏病心功能正常组相比较,慢性心衰组BNP、CRP浓度均明显升高.治疗后慢性心力衰竭治疗组总有效率87.9%,对照组总有效率75%(P＜0.05).结论:慢性心力衰竭患者存在非特异炎症反应,血浆BNP、CRP水平与患者心功能密切相关.丹参酮ⅡA磺酸钠注射液可改善CHF患者的心功能,其机制可能是通过增加心肌供血,抑制炎症反应而实现的.

Clinical Significance of Change of Plasma B-type Natriuretic Peptide and C-reactive Protein and Role of Sulfotanshinone Sodium Injection in Patients with Chronic Heart Failure

Objective:To observe the change in plasma BNP level and CRP level,and to explore the mechanism of Sulfotanshi- none Sodium injection in increasing myocardial blood-supply and improving cardiac function.Methods:The concentration of BNP in whole venous blood was determined with Triage Analyzer produced by BIOSITE C0.1td Americia,and that of CRP was determined with immunoturbidimetry assay.The concentrations of BNP and CRP were compared among the groups:normal group(n=20),control group with heart disease but non-dysfunction(n=31)and heart failure group(n=61).The relationship between the change in the concentration of BNP or CRP and cardiac function was analyzed.The heart failure group was divided into the treatment group(n=33)and the control group(n=28).Based on the same medicine therapy,the treatment group was treated with 60 mg of Sulfotanshinone Sodium Injection mixed 250 ml of 5% glucose per day for 15 days,and then the therapeutic effect and the change in plasma BNP and CRP level were ex- amined at the end of the course.Results:Compared with normal group and control group,the levels of plasma BNP and CRP in heart failure group decreased.The effective rate of Sulfotanshinone Sodium treatment group(87.9%)was higher than that of the control group (75.0%).Conclusions:Plasma BNP and CRP correlated closely with the cardiac function.There was a positive correlation between the nonspecific inflammatory reaction and the plasma BNP,CRP concentration.Sulfotanshinone Sodium Injection improved the cardiac function in patients with CHF by restraining inflammation and improving myocardial blood-supply.