Objective To explore the effects of recombinant human brain natriuretic peptide (rhBNP) on the cardiac function and ventricular remodeling in patients with chronic heart failure (CHF). Methods A total of 95 CHF patients, who admitted to Department of Geriatrics of our hospital from May 2012 to July 2015, were selected and ran-domly divided into the control group (n=47) and the observation group (n=48) according to random number table. The control group was treated with conventional drugs, and the observation group was treated with intravenous rhBNP on the basis of the control group. The two groups were treated for 3 d. The clinical efficacy of the two groups was compared. The indicators of cardiac function and ventricular remodeling of the two groups before and after treatment were mea-sured and compared by ultrasonic cardiogram. The levels of related neuroendocrine hormone of the two groups before and after treatment were detected and compared by radioactive immune analysis. The two groups were followed up for 6 months, and the occurrence of major adverse cardiac events (MACE) was recorded during following up. Results After the treatment, the clinical efficacy of the observation group was 89.58%, which was higher than 72.34%of the control group (P<0.05). The levels of N-terminal pro-brain nitric peptide (NT-proBNP), renin (R), angiotensinⅡ(AngⅡ), aldo-sterone (ALD), endothelin-1 (ET-1) and antidiuretic hormone (ADH) in 48 hours after the treatment were decreased, in addition to ALD and ADH, other indicators of the observation group were significantly lower than those of the control group (P<0.05 or 0.01). The left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVEDs) of the observation group after treated for 6 months were respectively (56.27±3.12) mm and (38.75±3.81) mm, which were significantly lower than before treatment (P<0.05 or 0.01). The left ventricular ejection fraction (LVEF), fractional shortening (FS), interventricular septum thickness (IVST) and left ventricular mass index (LVMI) after treated for 6 months in the observation group were respectively (38.38±4.05)%, (25.57±4.11)%, (10.22±0.61) mm and (129.61± 12.13) g/m2, which were significantly higher than those before treatment (P<0.01). In the control group, all the above in-dexes were significantly changed after the treatment (P<0.05). After treatment for 6 months, the LVEDd and LVEDs of the observation group were significantly lower than those of the control group, while the LVEF, FS, IVST and LVMI of the observation group were significantly higher than those of the control group (P<0.01). During follow-up, the occur-rence rate of MACE in observation group was 18.75%, which was significantly lower than 40.43%in control group (P<0.01). Conclusion rhBNP can inhibit ventricular remodeling, improve the prognosis and cardiac function of CHF pa-tients, significantly increase the clinical efficacy and reduce the occurrence of MACE.%目的：探讨重组人脑利钠肽(rhBNP)对慢性心力衰竭(CHF)患者心功能及心室重构的影响。方法选取2012年5月至2015年7月我院老年病科收治的CHF患者95例，按随机数表法分为对照组(n=47)与观察组(n=48)。对照组给予常规药物治疗，观察组在对照组治疗的基础上加用rhBNP静脉注射治疗，均治疗3 d。比较两组患者的临床疗效，采用超声心电图检测并比较两组患者治疗前后的心功能、心室重构指标，采用放射性免疫分析法检测并比较治疗前后两组患者的相关神经内分泌激素水平；治疗后随访6个月，记录随访过程中主要不良心脏事件(MACE)的发生情况。结果治疗后观察组患者的临床有效率为89.58%，明显高于对照组的72.34%，差异有统计学意义(P<0.05)；治疗48 h后血浆N末端脑利钠肽前体(NT-proBNP)、肾素(R)、血管紧张素(AngⅡ)、醛固酮(ALD)、内皮素(ET-1)及抗利尿激素(ADH)水平均下降，且除ALD、ADH外，观察组其他指标均显著低于对照组，差异均有统计学意义(P<0.05或0.01)；治疗后6个月，观察组左室舒张末期内径(LVEDd)为(56.27±3.12) mm，左室收缩末期内径(LVEDs)为(38.75±3.81) mm，均较治疗前显著下降(P<0.05或0.01)，观察组患者的射血分数(LVEF)为(38.38±4.05)%，内径缩短率(FS)为(25.57±4.11)%，室间隔厚度(IVST)为(10.22±0.61) mm，左室质量指数(LVMI)为(129.61±12.13) g/m2，均较治疗前显著升高，差异均有显著统计学意义(P<0.01)；对照组治疗后以上各项指标较治疗前也均有明显变化(P<0.05)，且治疗后6个月观察组LVEDd、LVEDs显著低于对照组，而观察组LVEF、FS、IVST及LVMI显著高于对照组，差异均有显著统计学意义(P<0.01)；随访期间，观察组MACE发生率为18.75%，明显低于对照组的40.43%，差异有显著统计学意义(P<0.01)。结论 rhBNP可抑制CHF患者心室重构，改善患者心功能，明显提高临床疗效并减少MACE的发生，改善患者预后。
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