| 但素平.最大耐受量β受体阻滞剂对NT-proBNP正常的射血分数改善的心力衰竭患者心功能和血清sST2的影响[J].实用中西医结合临床,2026,26(9): |
| 最大耐受量β受体阻滞剂对NT-proBNP正常的射血分数改善的心力衰竭患者心功能和血清sST2的影响 |
| Effect of β-blockers on cardiac function and serum sST2 in heart failure patients with Improved Ejection Fraction of normal NT-proBNP |
| 投稿时间：2025-06-14 修订日期：2025-07-19 |
| DOI： |
| 中文关键词: β受体阻滞剂 NT-proBNP 可溶性ST2 心功能 HFimpEF |
| 英文关键词: β-blockers NT-proBNP Soluble ST2 Heart function HFimpEF |
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| 中文摘要: |
| 目的： 探讨最大耐受量β受体阻滞剂是否能进一步改善N-末端脑钠肽前体（N-terminal pro-brain natriuretic peptide, NT-proBNP）正常的射血分数改善的心力衰竭（Heart failure with improved ejection fraction,HFimpEF）患者心功能，明确血清可溶性人基质裂解素-2（sST2）是否为更敏感指标。方法： 选取2022年1月至2023年6月期间在我院124例NT-proBNP水平正常的HFimpEF患者，根据不同治疗方法分为对照组（n=69）和干预组（n=55）。两组患者均接受HFimpEF的常规治疗，干预组在此基础上继续加量β受体阻滞剂至最大耐受量。连续治疗12个月后，比较两组患者的心功能、超声心动图指标[左心房直径（left atrial diameter, LAD）、左室收缩末期内径（left ventricular end systolic diameter, LVESD）、左室舒张末期内径（left ventricular end diastolic diameter, LVEDD）、左室射血分数（left ventricular ejection fraction, LVEF））]、血清sST2（soluble growth stimulating expression gene 2）水平。结果： 干预组的总有效率（80.9%，50/55）高于对照组（75.4%，52/69），差异有统计学意义（χ2 5.069,P=0.023）。治疗前，两组患者的超声心动图指标和血清sST2水平差异无统计学意义。治疗12个月后，两组LAD均低于治疗前（P＜0.05），而干预组LVESD、LVEDD、LVEF较前改善更为明显，差异有统计学意义（P<0.05）。此外，干预组的血清sST2改善水平也优于对照组，差异有统计学意义（P＜0.05）。结论： 最大耐受量β受体阻滞剂在常规治疗基础上能显著改善NT-proBNP正常的HFimpEF患者的心功能，血清sST2水平作为其改善指标可能更为灵敏。 |
| 英文摘要: |
| Objective: To investigate whether maximal tolerated doses of beta-blockers can further improve cardiac function in patients with heart failure with improved ejection fraction (HFimpEF) who have normal levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), and to determine whether serum soluble ST2 (sST2) is a more sensitive biomarker. Methods: A total of 124 patients with HFimpEF and normal NT-proBNP levels treated in our hospital from January 2022 to June 2023 were selected and divided into a control group (n=69) and an intervention group (n=55) based on different treatment methods. Both groups received conventional treatment for HFimpEF, while the intervention group further increased the dose of beta-blockers to the maximum tolerated level. After 12 months of continuous treatment, the cardiac function, echocardiographic parameters [left atrial diameter (LAD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF)], and serum sST2 levels were compared between the two groups.Results: The overall effective rate in the intervention group (80.9%, 50/55) was higher than that in the control group (75.4%, 52/69), with a statistically significant difference (χ2=5.069, P=0.023). Before treatment, there were no statistically significant differences in echocardiographic parameters and serum sST2 levels between the two groups. After 12 months of treatment, LAD in both groups was lower than before treatment (P<0.05). The improvements in LVESD, LVEDD, and LVEF were more significant in the intervention group compared to the control group, with statistically significant differences (P<0.05). Additionally, the improvement in serum sST2 levels was better in the intervention group than in the control group, with a statistically significant difference (P<0.05).Conclusion: Maximal tolerated doses of beta-blockers can significantly improve cardiac function in patients with HFimpEF and normal NT-proBNP levels, and serum sST2 levels may be a more sensitive indicator of improvement. |
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