缬沙坦对老年心力衰竭患者n端脑钠肽前体及和肽素的影响.docVIP

·临床研究· 缬沙坦对老年心力衰竭患者N端脑钠肽前体及和肽素的影响 陈福生1*, 蒲晓群2 （（1湖南株洲恺德心血管病医院心内科, 株洲 412007; 2中南大学湘雅医院心内科, 长沙 410008） 【摘 要】目的 观察老年慢性心力衰竭（简称“心衰”）患者缬沙坦治疗前后血浆N端脑钠肽前体（NT-proBNP）及和肽素的变化，探讨缬沙坦抑制心室重构的作用机制。方法 老年慢性心衰患者99例，随机分为治疗组（常规治疗+缬沙坦，n＝＝P＜0.05或0.01）；治疗组患者治疗1个月、6个月的血浆NT-proBNP、和肽素水平与同时间段对照组相比均下降，差异均有统计学意义（P＜0.05或0.01）。治疗1个月，两组患者左心室射血分数（LVEF）、左心室收缩末期内径（LVESd）及左心室舒张末期内径（LVEDd）与治疗前比较，以及两组相互比较，差异均无统计学意义；治疗6个月，治疗组LVEF较对照组明显升高（P＜0.01），LVESd及LVEDs较对照组明显减小(均P＜0.01)。结论 血管紧张素Ⅱ受体拮抗剂缬沙坦能够抑制老年慢性心衰患者血浆NT-proBNP、和肽素的分泌，抑制神经内分泌因子，抑制心室重构，改善心功能。 【关键词】老年心力衰竭; 缬沙坦; N端脑钠肽前体; 和肽素 【中图分类号】 R541.6+1 【文献标识码】 A 【DOI】 ? Effect of valsartan on NT-proBNP and copeptin in elderly patients with chronic heart failure CHEN Fu-Sheng1*, PU Xiao-Qun2 (1Department of Cardiology Kind-cardiovascular-disease Hospital of Zhuzhou, Zhuzhou 412000, China; 2Department of Cardiology, Xiangya Hospital, Central South University, Changsha 410008, China) 【Abstract】 Objective To determine the effects of valsartan on the plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and copeptin in the elderly patients with chronic heart failure (CHF), and to investigate the possible mechanism of valsartan to prevent ventricular remodeling. Methods A total of 99 CHF elderly patients who were at a mean age of 68?2 (ranging from 60 to 81) and hospitalized in our department from June 2011 to September 2012 were recruited in this study. They werew randomly divided into 2 groups, ie, valsartan and conventional treatment group (n=50), and conventional treatment (control group, n＝P0.05 or 0.01). Their levels were significantly lower in the valsartan treatment group than in the control in 1 and 6 month after treatment respectively (P0.05 or 0.01). No significant difference was found in the left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD) and left ventricular end diastole diameter (LVEDD) in the 2 groups between before and 1 month after treatment, and between the 2 groups at the 2