| 21 | 0 | 48 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 评估依库珠单抗注射液对心力衰竭患者血浆甘露糖结合凝集素相关丝氨酸蛋白酶3(MASP-3)和44 kDa甘露糖结合凝集素相关蛋白（MAp44）水平、心功能、炎症标志物及心肌损伤标志物的影响，探讨其治疗机制和临床应用前景。方法 前瞻性纳入2022年1月至2024年3月张家口市第一医院收治的100例心力衰竭患者，按照随机分配序列将患者分为观察组和对照组，每组50例。对照组接受常规药物治疗，观察组在对照组基础上接受依库珠单抗注射液治疗。分别在治疗前、治疗6周后和治疗12周后测量血浆MASP-3和MAp44水平，评估心功能指标（包括超声心动图和心电图参数）、炎症标志物（C反应蛋白、白细胞介素6）和心肌损伤标志物（肌钙蛋白I、脑钠肽）。结果 治疗6周后和12周后，观察组患者血浆MASP-3和MAp44水平显著低于治疗前（P<0.05），左室射血分数显著高于治疗前（P<0.05），左室舒张末期内径及左室收缩末期内径显著低于治疗前（P<0.05）,C反应蛋白、白细胞介素6、肌钙蛋白I、脑钠肽水平均显著低于治疗前（P<0.05）；治疗后，观察组上述指标均显著优于对照组（P<0.05）。结论 依库珠单抗注射液能有效调节补体系统，降低血浆MASP-3和MAp44水平，改善心功能并减轻心肌炎症损伤，为心力衰竭治疗提供了新思路，后续需深入探究其分子机制与长期疗效。
Abstract：Objective To evaluate the effects of eculizumab injection on plasma levels of mannan-binding lectinassociated serine protease 3(MASP-3) and mannan-binding lectin-associated protein 44(MAp44), cardiac function, inflammatory markers, and myocardial injury markers in patients with heart failure, and to explore its therapeutic mechanism and clinical application prospects. Methods A total of 100 patients with heart failure admitted to Zhangjiakou First Hospital between January 2022 and March 2024 were prospectively enrolled and divided into an observation group and a control group, with 50 patients in each group. The control group was administered conventional medication, while the observation group received eculizumab injection on the basis of the same conventional treatment regimen as the control group. Plasma MASP-3 and MAp44 levels were measured before treatment, after 6 weeks of treatment, and after 12 weeks of treatment. Cardiac function(including echocardiographic and electrocardiographic parameters), inflammatory markers[C-reactive protein(CRP), interleukin-6(IL-6)], and myocardial injury markers [cardiac troponin I(cTnI), brain natriuretic peptide(BNP)] were assessed at the same time points. Results After 6 and 12 weeks of treatment, plasma levels of MASP-3 and MAp44 in the observation group were significantly lower than those before treatment(P<0.05). Left ventricular ejection fraction was significantly higher than before treatment(P<0.05), while left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower(P<0.05). Levels of CRP, IL-6, cTnI, and BNP were also significantly lower than before treatment(P<0.05). After treatment, all the above indicators in the observation group were significantly better than those in the control group(P<0.05). Conclusion The eculizumab injection can effectively regulate the complement system, reduce plasma MASP-3 and MAp44 levels, improve cardiac function, and alleviate myocardial inflammatory injury. It provides a new approach for the treatment of heart failure. Further studies are needed to investigate its specific molecular mechanisms and long-term efficacy.
[1]柴睿,黄辉,张望强.血清胎盘生长因子和脑啡肽酶对老年心力衰竭患者心功能分级和心肌损伤的预测作用[J].中华老年心脑血管病杂志, 2023, 25(9):913-917. DOI:10.3969/j.issn.1009-0126.2023.09.005.
[2]王倩,蒋雄京,何际宁,等.肾动脉狭窄致心力衰竭患者的临床特征及诊治经验[J].实用心脑肺血管病杂志, 2021, 29(6):116-123.DOI:10.12114/j.issn.1008-5971.2021.00.121.
[3]朱小凤,杨丽玫.血浆脑利钠肽与心脏彩超联合应用对老年性心力衰竭的诊断及预后评估意义[J].海军医学杂志, 2020, 41(4):470-472. DOI:10.3969/j.issn.1009-0754.2020.04.041.
[4]丁爱梅,曹祯,王向明,等.血浆CTRP3, angptl2水平与老年慢性心力衰竭患者左心室重构的相关性[J].疑难病杂志, 2021, 20(9):894-898. DOI:10.3969/j.issn.1671-6450.2021.09.007.
[5]吴媛媛,陈莉,李翠翠,等.血浆促生长激素释放多肽,脑钠肽水平与急性心肌梗死患者心力衰竭的关系研究[J].实用心脑肺血管病杂志, 2020, 28(3):40-43+50. DOI:10.3969/j.issn.1008-5971.2020.03.009.
[6]刘玲玲,颜永进.高血压合并心力衰竭患者血脂指标及比值与左心室重构的关系研究[J].转化医学杂志, 2022, 11(5):319-322.DOI:10.3969/j.issn.2095-3097.2022.05.013.
[7]陈琳琳,周娟,周瑾. PCI术联合替罗非班对STEMI患者心室跨壁复极离散度的影响及其预后的高危因素分析[J].转化医学杂志,2022, 11(6):369-373. DOI:10.3969/j.issn.2095-3097.2022.06.009.
[8]李源繁,杨国杰,李栋博,等.慢性心力衰竭患者血浆cMyBP-C水平的变化[J].临床心血管病杂志, 2020, 36(8):755-759.DOI:10.13201/j.issn.1001-1439.2020.08.016.
[9]Petrie MC, Verma S, Docherty KF, et al. Effect of dapagliflozin on worsening heart failure and cardiovascular death in patients with heart failure with and without diabetes[J]. JAMA, 2020, 323(14):1353-1368.DOI:10.1001/jama.2020.1906.
[10]中华医学会心血管病学分会,中国医师协会心血管内科医师分会,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2024[J].中华心血管病杂志,2024, 52(3):235-275. DOI:10.3760/cma.j.cn112148-20231101-00405.
[11]Lund A, Nordrehaug JE, Slettom G, et al. Plasma kynurenines and prognosis in patients with heart failure[J]. PLoS One, 2020, 15(1):e0227365. DOI:10.1371/journal.pone.0227365
[12]Benz AP, Hijazi Z, Lindbäck J, et al. Plasma angiopoietin-2 and its association with heart failure in patients with atrial fibrillation[J]. Europace, 2023, 25(7):euad200. DOI:10.1093/europace/euad200.
[13]Huang R, Wang Z, Chen J, et al. Prognostic value of triglyceride glucose(Ty G)index in patients with acute decompensated heart failure[J]. Cardiovasc Diabetol, 2022, 21(1):88. DOI:10.1186/s12933-022-01507-7.
[14]Jin N, Huang L, Hong J, et al. Elevated homocysteine levels in patients with heart failure:A systematic review and meta-analysis[J]. Medicine(Baltimore), 2021, 100(33):e26875. DOI:10.1097/MD.0000000000026875.
[15]Shiina K, Tomiyama H, Tanaka A, et al. Canagliflozin independently reduced plasma volume from conventional diuretics in patients with type 2diabetes and chronic heart failure:a subanalysis of the CANDLE trial[J].Hypertens Res, 2023, 46(2):495-506. DOI:10.1038/s41440-022-01085-x.
[16]Zozina VI, Kondratenko SN, Shikh EV, et al. The influence of atorvastatin, amlodipine and ethoxidol on ubiquinol and ubiquinone endogenous plasma concentrations in patients with chronic heart failure[J]. Curr Drug Metab, 2023, 24(9):635-644. DOI:10.2174/1389200224666230913133201.
[17]Lin SM, Chang CH, Lin TY, et al. Plasma thrombomodulin levels are associated with acute kidney injury in patients with acute heart failure[J]. Ann Med, 2022, 54(1):3169-3176. DOI:10.1080/07853890.2022.2142660.
[18]Schnelle M, Leha A, Eidizadeh A, et al. Plasma biomarker profiling in heart failure patients with preserved ejection fraction before and after spironolactone treatment:results from the Aldo-DHF trial[J]. Cells,2021, 10(10):2796. DOI:10.3390/cells10102796.
[19]Swolinsky JS, Tuvshinbat E, Leistner DM, et al. Discordance between estimated and measured changes in plasma volume among patients with acute heart failure[J]. ESC Heart Fail, 2022, 9(1):66-76.DOI:10.1002/ehf2.13739.
[20]Ahmad F, Karim A, Khan J, et al. Plasma galectin-3 and H-FABP correlate with poor physical performance in patients with congestive heart failure[J]. Exp Biol Med(Maywood), 2023, 248(6):532-540.DOI:10.1177/15353702231151980.
[21]Li C, Zhao M, Xiao L, et al. Prognostic value of elevated levels of plasma N-acetylneuraminic acid in patients with heart failure[J]. Circ Heart Fail, 2021, 14(11):e008459. DOI:10.1161/CIRCHEARTFAILURE.121.008459.
[22]Kologrivova I, Shtatolkina M, Suslova T, et al. Cells of the immune system in cardiac remodeling:main players in resolution of inflammation and repair after myocardial infarction[J]. Front Immunol, 2021,12:664457. DOI:10.3389/fimmu.2021.664457.
[23]Jin K, Ma Z, Wang X, et al. The role of cardiac macrophages in inflammation and fibrosis after myocardial ischemia-reperfusion[J]. Rev Cardiovasc Med, 2024, 25(11):419. DOI:10.31083/j.rcm2511419.
[24]Saeed N, Steiro OT, Langørgen J, et al. Diagnosing myocardial injury in an acute chest pain cohort; long-term prognostic implications of cardiac troponin T and I[J]. Clin Chem, 2024, 70(10):1241-1255.DOI:10.1093/clinchem/hvae110.
[25]Goina CA, Goina DM, Farcas SS, et al. The role of circular RNA for early diagnosis and improved management of patients with cardiovascular diseases[J]. Int J Mol Sci, 2024, 25(5):2986-2990.DOI:10.3390/ijms25052986.
基本信息:
中图分类号:R541.6
引用信息:
[1]李荷云,宋宸晏,王媛媛.依库珠单抗注射液对心力衰竭患者血浆MASP-3和MAp44水平、心功能、炎症标志物及心肌损伤标志物的影响[J].转化医学杂志,2026,15(03):501-505.
基金信息:
2022年河北省医学科学研究课题计划（20221893）
2026-03-18
2026-03-18