贝那普利对慢性心力衰竭患者血清和肽素及N端脑钠肽前体的影响被引量：6

Effect of benazepril on plasma copeptin and N terminal brain natriuretic peptide in patients with chronicheart failure

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摘要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）、（43．24-5．6）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（57．54-5．4）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。 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 weremeasured 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 ） mm, 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 CI-IF patients, inhibit neuroendocrine and the ventricular remodeling, and then improve the heart function.

作者陈福生罗莘蒲晓群

机构地区湖南省株洲恺德心血管病医院心内科中南大学湘雅医院心内科

出处《中国综合临床》 2014年第1期48-51,共4页 Clinical Medicine of China

关键词心力衰竭和肽素 N端脑钠肽前体贝那普利 Heart failure Copeptin N terminal brain natriuretic peptide Benazepril

分类号 R541.6 [医药卫生—心血管疾病]

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