目的 探討重組人腦利鈉肽治療急性失代償性心力衰竭的療效及其對血清可溶性生長刺激表達基因2（sST2）、心肌營養(yǎng)素1（CT-1）水平的影響。方法 選取2018年3月-2020年1月在河北醫(yī)科大學第二醫(yī)院治療的急性失代償性心力衰竭患者90例作為研究對象，將患者隨機分為對照組（n=45）和觀察組（n=45）。對照組患者給予常規(guī)抗心力衰竭治療。觀察組在常規(guī)抗心力衰竭治療的基礎上給予注射用重組人腦利鈉肽治療，前3 min以負荷量為1.5 μg/kg進行靜脈沖擊，接下來72 h使用0.007 5 μg/（kg·min）進行靜脈滴注，兩組均連續(xù)治療2周。觀察兩組患者的臨床療效，同時比較兩組患者的心、腎功能指標，血清可溶性生長刺激表達基因2（sST2）、心肌營養(yǎng)素1（CT-1）水平。結果 治療后，觀察組患者總有效率為88.89%，顯著高于對照組的64.44%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者左心室收縮末期內徑（LVESD）、左心室收縮末期容積（LVESV）顯著降低，左室射血分數（LVEF）顯著升高（P<0.05）；且觀察組LVESD、LVESV低于對照組，LVEF高于對照組（P<0.05）。治療后，兩組胱抑素C （Cys-C）、血肌酐（Scr）水平顯著降低，腎小球濾過率（GFR）水平顯著升高（P<0.05）；且觀察組Cys-C、Scr水平顯著低于對照組，GFR水平高于對照組（P<0.05）。治療后，兩組血清sST2、CT-1水平較治療前顯著降低（P<0.05），且觀察組血清sST2、CT-1水平低于對照組（P<0.05）。結論 重組人腦利鈉肽治療可降低急性失代償性心力衰竭患者血清sST2、CT-1水平，提高患者的心、腎功能，提高臨床療效，改善患者預后，具有重要臨床價值。

Objective To investigate the efficacy of recombinant human brain natriuretic peptide in treatment of acute decompensated heart failure and its effect on serum SST2 and CT-1 levels. Methods A total of 90 patients with acute decompensated heart failure who were treated in the Second Hospital of Hebei Medical University from March 2018 to January 2020 were selected as the research subjects, and the patients were randomly divided into control group (n=45) and observation group (n=45). Patients in the control group received conventional antiheart failure therapy. Patients in the observation group were given Lyophilized Recombinant Human Brain Natriuretic Peptide on the basis of conventional anti-heart failure therapy. The first 3 min was injected with 1.5 μg/kg, and the next 72 h was injected with 0.007 5 μg/(kg·min). The two groups were treated for 2 weeks. The clinical efficacy of two groups was observed, and the indexes of heart and kidney function, serum SST2 and CT-1 were compared between two groups. After treatment, the total effective rate of the observation group was 88.89%, which was significantly higher than 64.44% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, LVESD and LVESV in two groups were significantly decreased, while LVEF was significantly increased (P<0.05). After treatment, LVESD and LVESV of the observation group were lower than those of the control group, and LVEF of the observation group was higher than that of the control group (P<0.05). After treatment, the levels of Cys-C and Scr in two groups were significantly decreased, while the GFR level was significantly increased (P<0.05). The levels of Cys-C and Scr in the observation group were significantly lower than those in the control group, and the levels of GFR in the observation group were higher than those in the control group (P<0.05). After treatment, the serum SST2 and CT-1 levels in two groups were significantly decreased compared with before treatment (P<0.05), and the serum SST2 and CT-1 levels in the observation group were lower than those in the control group (P<0.05). Conclusion Recombinant human brain natriuretic peptide therapy can reduce serum SST2 and CT-1 levels in patients with acute decompensated heart failure, improve cardiac and renal functions, improve clinical efficacy and improve prognosis of patients, which has important clinical value.

R972

河北省衛(wèi)生健康委科研基金項目（20170578）