2025 年第 12 期 第 20 卷

左西孟旦及重组人脑利钠肽用于急性心肌梗死合并心力衰竭患者的疗效及对B型脑钠肽和心功能的影响

The efficacy of levosimendan and recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicated with heart failure and its influence on brain natriuretic peptide and cardiac function

作者：邱洪1陈琳1杜颖强2叶加宝1

英文作者：Qiu Hong1 Chen Lin1 Du Yingqiang2 Ye Jiabao1

单位：1南京医科大学附属苏州医院（苏州市立医院）心血管中心，苏州215000；2南京医科大学附属苏州医院（苏州市立医院）心内科，苏州215000

英文单位：1Cardiovascular Center the Affiliated Suzhou Hospital of Nanjing Medical University Suzhou Municipal Hospital Suzhou 215000 China; 2Department of Cardiology the Affiliated Suzhou Hospital of Nanjing Medical University Suzhou Municipal Hospital Suzhou 215000 China

关键词：急性心肌梗死；心力衰竭；左西孟旦；重组人脑利钠肽；B型脑钠肽；心功能

英文关键词：Acutemyocardialinfarction;Heartfailure;Levosimendan;Recombinanthumanbrainnatriureticpeptide;Brainnatriureticpeptide;Cardiacfunction

• 摘要：

• 目的 探究左西孟旦及重组人脑利钠肽用于急性心肌梗死（AMI）合并心力衰竭患者的疗效及对B型脑钠肽（BNP）、心功能的影响。方法 选取2022年1月至2025年1月南京医科大学附属苏州医院收治的AMI合并心力衰竭患者120例，采用随机数字表法分为单药组（左西孟旦治疗）和联合组（左西孟旦联合重组人脑利肽治疗），各60例。比较2组疗效和心肌肌钙蛋白I（cTnI）、BNP、可溶性肿瘤发生抑制蛋白2（sST2）、尾加压素Ⅱ、白细胞介素1β（IL-1β）、基质金属蛋白酶9（MMP-9）、高敏C反应蛋白（hs-CRP）、亲环素A水平及左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）水平，并分析2组用药不良反应情况。结果 联合组总有效率明显高于单药组［93.3%(56/60)比80.0%(48/60)］（P=0.032）。2组治疗后BNP、cTnI、sST2水平均下降，尾加压素Ⅱ水平均上升，且组间相较联合组均更优（均P＜0.05）。2组治疗后LVEDD、LVESD水平均减小，LVEF水平均上升，且组间相较联合组均更优（均P＜0.05）。2组治疗后IL-1β、MMP-9、hs-CRP、亲环素A水平均下降，且组间相较联合组均更低（均P＜0.05）。2组不良反应发生率比较差异无统计学意义（P＞0.05）。结论 左西孟旦、重组人脑利钠肽联合治疗AMI合并心力衰竭，可显著降低BNP水平，改善患者心功能，缓解炎症反应，提升临床疗效，且安全性良好。

• Objective To investigate the efficacy of levosimendan and recombinant human brain natriuretic peptide in patients with acute myocardial infarction (AMI) complicated with heart failure and its effect on brain natriuretic peptide (BNP) and cardiac function. Methods A total of 120 patients with AMI complicated with heart failure admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2022 to January 2025 were selected, and they were divided into single-drug group (levosimendan treatment) and combination group (levosimendan combined with recombinant human brain natriuretic peptide treatment) by random number table method, with 60 cases in each group. The therapeutic effects, levels of cardiac troponin I (cTnI), BNP, soluble tumor suppressor protein 2 (sST2), urotensin Ⅱ, interleukin-1β (IL-1β), matrix metalloproteinase 9 (MMP-9), high sensitive C-reactive protein (hs-CRP), cyclophilin A, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were compared between the two groups. The adverse drug reactions of the two groups were analyzed. Results The total effective rate of the combination group was significantly higher than that of the single-drug group ［93.3%(56/60) vs 80.0%(48/60)］（P=0.032）. After treatment, the levels of BNP, cTnI and sST2 in the two groups decreased, and the level of urotensin Ⅱ increased, and the comparison between the two groups showed that the combination group was better (all P＜0.05). After treatment, the levels of LVEDD and LVESD in the two groups reduced, and the level of LVEF increased, and the comparison between the two groups showed that the combination group was better (all P＜0.05). The levels of IL-1β, MMP-9, hs-CRP and cyclophilin A in the two groups decreased after treatment, and the comparison between the two groups showed that the combination group was lower (all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion Levosimendan combined with recombinant human brain natriuretic peptide in the treatment of AMI complicated with heart failure can significantly reduce the level of BNP, improve the cardiac function of patients, alleviate the inflammatory response, improve the clinical efficacy, and has good safety.