The Change Of N-terminal Pro-B-type Natriuretic Peptide And Red Cell Distribution Width In Patients With Chronic Systolic Heart Failure, And The Effect Of Levosimendan

Objective：N-terminal pro-B-type natriuretic peptide（NT-proBNP）, red blood cell distribution width（RDW）, hypersensitive c-reactive protein （hs-CRP） and left ventricular ejection fraction （LVEF）etc. were measured in patients with chronic systolicheart failure(CHF), to investigate the changes of these index, the relationship with the severity of CHF, and the effect of Levosimendan in patients with CHF.Methods：120patients with CHF were seleted from2012-2014in Yantai economic and Technological Development Zone Hospital and Yantai Yu Huang Ding Hospital, which were divided into the leosimendan group and routine treatment group. The baseline data of two groups, such as age, sex, body mass index, smoking and alcohol, liver function, kidney function test indexes had no statistical difference. All patients with CHF were observed for14days after treatment. The routine treatment group are given standard heart failure therapy (ACEI, ARB, beta blockers,diuretic drugs, digitalis drugs, nitrate etc.). The levosimendan (levosimendan injections, yuewen, Qilu pharmaceutical Company) were given in the leosimendan group in addition to routine treatment. First vein for12ug/kg load, with0.05ug/kg/min for the initial dosage vein pump, maintenance dosage adjustment range is0.05ug/kg/min to0.2ug/kg/min, ensure that systolic blood pressure≥90mmHg, or an average pressure of≥65mmHg, and heart rate≤150times/min. The dosageadjustment which last24hours was done under rigorous monitoring by physicians. NT-proBNP, RDW, hs–CRP and LVEF were measured on the day of admission (before treatment),7days and14days after treatment. The changes of these index and the effect of Levosimendan were compare and analysed.30persons with outpatient health physical examination were seleted to mesure the NT-proBNP, RDW, hs–CRP and LVEF as control group.Results:1. The plasma level of NT-proBNP, RDW and hs-CRP were significantly lower,LVEF was significantly higher in the two groups of patients with CHF after treatment than before (P<0.05). The level of NT-proBNP, RDW and hs-CRP were significantly lower, LVEF was significantly higher in levosimendan group after7days treatment and14days treatment than routine treatment group separately (P<0.05).2. The level of NT-proBNP, RDW and hs-CRP were significantly higher, LVEFwas significantly lower in NYHA fuction Ⅱ, Ⅲ, Ⅳ group of patients with CHFbefore teeatment than control group (P<0.05). The level of NT-proBNP, RDWand hs-CRP were significantly higher, LVEF was significantly lower in NYHA fuction Ⅲ group of patients with CHF before teeatment than NYHA fuction Ⅱ group (P <0.05).The level of NT-proBNP, RDW and hs-CRP were significantly higher, LVEF was significantly lower in NYHA fuction Ⅳ group of patients withCHF before teeatment than NYHA fuction Ⅱ, Ⅲ group (P<0.05).3. The level of NT-proBNP, RDW and hs-CRP were significantly lower, LVEFwas significantly higher in NYHA fuction Ⅱ, Ⅲ, Ⅳ group of patients with CHF after after7days treatment and14days treatment than before respectively (P<0.05).4. There were correlation between NT-proBNP, RDW, hs–CRP and LVEF in thepatients with CHF（r=-0.695,-0.847,-0.346respectively, P<0.05）. There were higher correlation between NT-proBNP, RDW,hs–CRP and NYHA fuction in the patients with CHF（r=0.771、0.884、0.496respectively, P <0.05）.Conclusion:1. The plasma levels of NT-proBNP, RDW, hs-CRP, LVEF in patients with different NYHA fuction grade were significantly different. NT-proBNP, RDW, hs-CRP increased,LVEF decreased with the increase of NYHA fuction grade.2. The levels of NT-proBNP, RDW, hs-CRP, LVEF were significantly improved after7days treatment and14days treatment in all patients with CHF (include the leosimendan group and routine treatment group) than before the treatment.3. Levosimendan is more effective to decrease NT-proBNP, RDW, hs-CRP and increase LVEF than routine treatment.