中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
1期
48-51
,共4页
心力衰竭%和肽素%N端脑钠肽前体%贝那普利
心力衰竭%和肽素%N耑腦鈉肽前體%貝那普利
심력쇠갈%화태소%N단뇌납태전체%패나보리
Heart failure%Copeptin%N terminal brain natriuretic peptide%Benazepril
目的 观察贝那普利对慢性心力衰竭患者血清和肽素及N端脑钠肽前体(NT-proBNP)的影响,探讨贝那普利抑制心室重构的作用机制.方法 慢性心力衰竭患者238例随机分为对照组118例(强心、利尿、扩血管等常规药物治疗),治疗组120例(常规药物治疗±贝那普利).两组均连续治疗6个月.治疗前、后行血清和肽素、NT-proBNP浓度检测;并检测慢性心力衰竭患者治疗前、后左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)的变化;对比两组各指标变化的差异.结果 治疗组治疗前、后和肽素[(17.8±7.9)、(4.9±1.3) pmol/L,t=7.331,P=0.008]、NT-proBNP[(1779.6±838.3)、(327.8±226.8)ng/L,t=10.236,P=0.002]、LVEF[(33.5±6.2)％、(50.5±5.2)％,t=3.336,P =0.009]、LVESD[(47.6±8.9)、(32.9±5.7) mm,t=2.767,P=0.010]、LVEDD[(60.2±7.1)、(43.2±5.6) mm,t=2.882,P=0.009]比较差异均有统计学意义.治疗6个月,治疗组各指标与对照组[对照组:和肽素为(10.5±2.4) nmol/L; NT-proBNP为(1076.6±486.6) pg/L,LVEF为(36.6±5.6)％,LVESD为(45.9±6.8) mm,LVEDD为(57.5±5.4) mm]比较差异均有统计学意义(P值分别为0.049、0.010、0.035、0.038、0.048).结论 贝那普利可降低慢性心力衰竭患者血清和肽素、NT-proBNP的浓度,抑制神经内分泌因子,抑制心室重构,改善心功能.
目的 觀察貝那普利對慢性心力衰竭患者血清和肽素及N耑腦鈉肽前體(NT-proBNP)的影響,探討貝那普利抑製心室重構的作用機製.方法 慢性心力衰竭患者238例隨機分為對照組118例(彊心、利尿、擴血管等常規藥物治療),治療組120例(常規藥物治療±貝那普利).兩組均連續治療6箇月.治療前、後行血清和肽素、NT-proBNP濃度檢測;併檢測慢性心力衰竭患者治療前、後左心室射血分數(LVEF)、左心室收縮末期內徑(LVESD)及左心室舒張末期內徑(LVEDD)的變化;對比兩組各指標變化的差異.結果 治療組治療前、後和肽素[(17.8±7.9)、(4.9±1.3) pmol/L,t=7.331,P=0.008]、NT-proBNP[(1779.6±838.3)、(327.8±226.8)ng/L,t=10.236,P=0.002]、LVEF[(33.5±6.2)％、(50.5±5.2)％,t=3.336,P =0.009]、LVESD[(47.6±8.9)、(32.9±5.7) mm,t=2.767,P=0.010]、LVEDD[(60.2±7.1)、(43.2±5.6) mm,t=2.882,P=0.009]比較差異均有統計學意義.治療6箇月,治療組各指標與對照組[對照組:和肽素為(10.5±2.4) nmol/L; NT-proBNP為(1076.6±486.6) pg/L,LVEF為(36.6±5.6)％,LVESD為(45.9±6.8) mm,LVEDD為(57.5±5.4) mm]比較差異均有統計學意義(P值分彆為0.049、0.010、0.035、0.038、0.048).結論 貝那普利可降低慢性心力衰竭患者血清和肽素、NT-proBNP的濃度,抑製神經內分泌因子,抑製心室重構,改善心功能.
목적 관찰패나보리대만성심력쇠갈환자혈청화태소급N단뇌납태전체(NT-proBNP)적영향,탐토패나보리억제심실중구적작용궤제.방법 만성심력쇠갈환자238례수궤분위대조조118례(강심、이뇨、확혈관등상규약물치료),치료조120례(상규약물치료±패나보리).량조균련속치료6개월.치료전、후행혈청화태소、NT-proBNP농도검측;병검측만성심력쇠갈환자치료전、후좌심실사혈분수(LVEF)、좌심실수축말기내경(LVESD)급좌심실서장말기내경(LVEDD)적변화;대비량조각지표변화적차이.결과 치료조치료전、후화태소[(17.8±7.9)、(4.9±1.3) pmol/L,t=7.331,P=0.008]、NT-proBNP[(1779.6±838.3)、(327.8±226.8)ng/L,t=10.236,P=0.002]、LVEF[(33.5±6.2)％、(50.5±5.2)％,t=3.336,P =0.009]、LVESD[(47.6±8.9)、(32.9±5.7) mm,t=2.767,P=0.010]、LVEDD[(60.2±7.1)、(43.2±5.6) mm,t=2.882,P=0.009]비교차이균유통계학의의.치료6개월,치료조각지표여대조조[대조조:화태소위(10.5±2.4) nmol/L; NT-proBNP위(1076.6±486.6) pg/L,LVEF위(36.6±5.6)％,LVESD위(45.9±6.8) mm,LVEDD위(57.5±5.4) mm]비교차이균유통계학의의(P치분별위0.049、0.010、0.035、0.038、0.048).결론 패나보리가강저만성심력쇠갈환자혈청화태소、NT-proBNP적농도,억제신경내분비인자,억제심실중구,개선심공능.
Objective To investigate the effects of benazepril on plasma copeptin and N terminal brain natriuretic peptide (NT-proBNP) in the patients with chronic heart failure (CHF) in order to explore the mechanism of benazepril on ventricular remodeling.Methods Two hundred and thirty-eight patients with CHF were randomized into control group (n =118) and therapy group (n =120).Patients in control group were received regular treatment including medicine of treating cardiotonic diuretic and vasodilator for 6 months,while in therapy group were given benazepril beside regular treatment.The levels of copeptin,NT-proBNP were measured before and after treatment.The left ventricular ejection fraction (LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end diastole diameter(LVEDD) were recorded and compared before and after treatment.Results In treatment group,the levels of copeptin and NT-pro BNP,LVEF,LVEDD,LVESD were (4.9 ± 1.3) pmol/L and (327.8 ± 226.8) ng/L,(33.5 ± 6.2) ％,(47.6 ± 8.9) mm,(60.2 ± 7.1) mm before treatment,different from that after treatment ((17.8 ± 7.9) pmol/L,t =7.331,P =0.008 ; (1 779.6±838.3) pg/mL,t =10.236,P =0.002; (50.5 ±5.2)％,t =3.336,P=0.009;(32.9 ±5.7) mm,t =2.767,P =0.010 ; (43.2 ± 5.6) rmm,t =2.882,P =0.009).After treatment the levels of copeptin,NT-proBNP,LVEF,LVESD and LVEDD in treatment were lower than that of control group(control group:copeptin:(10.5 ± 2.4) nmol/L; NT-proBNP:(1076.6 ± 486.6) pg/L; LVEF:(36.6 ± 5.6) ％ ; LVESD:(45.9 ± 6.8)mm; LVEDD:(57.5 ± 5.4) mm),and there was significant difference between groups (P =0.049,0.010,0.035,0.038,0.048 respectively).Conclusion Benazepril treatment could decrease the level of plasma copeptin and NT-proBNP in CHF patients,inhibit neuroendocrine and the ventricular remodeling,and then improve the heart function.
