目的 探讨重组人脑利钠肽治疗急性失代偿性心力衰竭的疗效及其对血清可溶性生长刺激表达基因2（sST2）、心肌营养素1（CT-1）水平的影响。方法 选取2018年3月-2020年1月在河北医科大学第二医院治疗的急性失代偿性心力衰竭患者90例作为研究对象，将患者随机分为对照组（n=45）和观察组（n=45）。对照组患者给予常规抗心力衰竭治疗。观察组在常规抗心力衰竭治疗的基础上给予注射用重组人脑利钠肽治疗，前3 min以负荷量为1.5 μg/kg进行静脉冲击，接下来72 h使用0.007 5 μg/（kg·min）进行静脉滴注，两组均连续治疗2周。观察两组患者的临床疗效，同时比较两组患者的心、肾功能指标，血清可溶性生长刺激表达基因2（sST2）、心肌营养素1（CT-1）水平。结果 治疗后，观察组患者总有效率为88.89%，显著高于对照组的64.44%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者左心室收缩末期内径（LVESD）、左心室收缩末期容积（LVESV）显著降低，左室射血分数（LVEF）显著升高（P<0.05）；且观察组LVESD、LVESV低于对照组，LVEF高于对照组（P<0.05）。治疗后，两组胱抑素C （Cys-C）、血肌酐（Scr）水平显著降低，肾小球滤过率（GFR）水平显著升高（P<0.05）；且观察组Cys-C、Scr水平显著低于对照组，GFR水平高于对照组（P<0.05）。治疗后，两组血清sST2、CT-1水平较治疗前显著降低（P<0.05），且观察组血清sST2、CT-1水平低于对照组（P<0.05）。结论 重组人脑利钠肽治疗可降低急性失代偿性心力衰竭患者血清sST2、CT-1水平，提高患者的心、肾功能，提高临床疗效，改善患者预后，具有重要临床价值。

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

河北省卫生健康委科研基金项目（20170578）