血管紧张素受体-脑啡肽酶抑制剂对射血分数保留心衰患者肾脏功能及血清BNP、VEGF、TNF-α水平的影响

摘要/Abstract

摘要： 目的:探究以血管紧张素受体-脑啡肽酶抑制剂（ARNI）治疗射血分数保留的心衰患者，对肾脏功能及血清B型钠尿肽(brain natriuretic peptide，BNP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)以及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的影响。方法:选取2020年1月至2021年1月某医疗中心收治的94例射血分数保留的心衰患者，采用随机方式分为观察组和对照组。其中对照组采用常规治疗，观察组采用ARNI治疗。比较两组的临床疗效，血清BNP、VEGF、TNF-α水平以及治疗安全性。结果:观察组治疗总有效率高于对照组（P＜0.05）。治疗前，两组患者血清BNP、VEGF、TNF-α水平比较，差异无统计学意义（P＞0.05）；治疗后，两组患者血清VEGF均升高，BNP、TNF-α均下降，其中观察组变化幅度更显著（P＜0.05）。两组患者血清肌酐(Scr)、胱抑素C(CysC)水平、24h尿量和血钾未见异常情况，组间比较差异无统计学意义（P>0.05），症状性低血压发生率差异无统计学意义（P＞0.05）。结论:ARNI治疗对射血分数保留的心衰患者血清BNP、VEGF、TNF-α水平有积极影响，对肾脏功能无显著影响。

关键词: font-size:medium, ">血管紧张素受体-脑啡肽酶抑制剂；射血分数保留；心力衰竭；B型钠尿肽；血管内皮生长因子；肿瘤坏死因子-α

Abstract: Objective: To investigate the effects of angiotensin receptor-neprilysin inhibitor (ARNI) on renal function and serum brain natriuretic peptide (BNP), vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) levels of patients with heart failure with ejection fraction preservation (HfpEF). Methods: A total of 94 patients with HfpEF admitted to a medical center from January 2020 to January 2021 were selected. According to the randomized double-blind approach, they were divided into the observation group and the control group. The observation group was treated with ARNI, while the control group was treated with routine treatment. The clinical efficacy, serum BNP, VEGF, TNF-α levels and the safety of the treatment were compared between the two groups. Results: The total effective rate of clinical efficacy of the observation group was higher than that of the control group (P<0.05). Before treatment, there were no significant difference in BNP, VEGF and TNF-α levels between the two groups (P>0.05). After treatment, the serum VEGF level increased, BNP and TNF-α levels decreased in both two groups of paitents, and the change of the observation group was more obviously than the control group (P<0.05). There was no significant difference in SCR, CysC, 24 h urine volume, incidence of symptomatic hypotension and blood potassium between the two groups of patients (P>0.05).Conclusion: ARNI has positive effects on serum BNP, VEGF and TNF-α levels in patients with HfpEF, but has no significant effect on kidney function of HfpEF patients.

Key words: ARNI； Ejection fraction retention, Heart failure； BNP, VEGF, TNF-α

中图分类号:

程向娟, 刘秋平, 葛婕丽, 刘雅琳, 陈珍珍. 血管紧张素受体-脑啡肽酶抑制剂对射血分数保留心衰患者肾脏功能及血清BNP、VEGF、TNF-α水平的影响[J]. 中国医药导刊, 2021, 23(11): 809-813.

CHENG Xiangjuan, LIU Qiuping, GE Jieli, LIU Yalin, CHEN Zhenzhen. Effects of Angiotensin Receptor- Neprilysin Inhibitor on Renal Function and Serum BNP, VEGF and TNF-α Levels of Patients with Heart Failure with Preserved Ejection Fraction[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(11): 809-813.

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