摘要
目的研究替米沙坦对永久性心脏起搏患者血浆脑利钠肽（BNP）的影响。方法选取永久性心脏起搏患者106例，根据随机数字表法分为研究组和对照组，每组53例。研究组给予替米沙坦片，每日1次，每次1片，直至随访结束。对照组常规给予缬沙坦。两组均于给药前和随访结束后应用荧光免疫法检测血浆BNP水平，超声心动图测定左室射血分数（LVEF）和心脏指数（CI）。结果给药前两组患者血浆BNP水平均低于100ng／L，且两组比较差异无统计学意义（P〉0．05）。随访结束后，研究组血浆BNP水平轻微变化，而对照组血浆BNP水平显著升高，并且明显高于同期研究组[（105．67±15．64）ng／L比（73．23±10．56）ng／L]，差异有统计学意义（P〈0．05）。研究组给药前、随访结束后LVEF和CI基本平稳[（58±4）％比（594±5）％、（3．584±0．32）L／（min·m。）比（3．56±0．26）L／（min·m：）]，均保持在正常范围内。对照组随访结束后LVEF、CI显著下降[（49±3）％比（564±3）％、（2．97±0．26）L／（min·m^2）比（3．624±0．29）L／（min·m^2）]，并且明显低于同期研究组[（494±3）％比（594±5）％、（2．974±0．26）L／（min·m^2）比（3．56±0．26）L／（min·m^2）]，差异均有统计学意义（P〈0．05）。结论替米沙坦可以延缓永久性心脏起搏患者血浆BNP水平的增加，从而延缓心力衰竭症状的出现，提高生活质量。对于起搏治疗的患者建议早期服用替米沙坦。
Objective To investigate the effect of telmisartan on the plasma brain natriuretic peptide （BNP） in patients with permanent cardiac pacing. Methods According to the method of simple random numbers, 106 patients with permanent cardiac pacing were randomly divided into study group and control group, with 53 cases in each group. All patients received implanted operation of permanent pacemaker. The study group was given telmisartan tablets, 1 time a day, 1 tablet each time, until the end of follow-up. The control group was given valsartan. The plasma BNP was measured by the immunofluorescent assay before administration and at the end of follow-up. In addition, left ventricular ejection fraction （LVEF） and cardiac index （CI） was determined by echocardiography. Results The plasma BNP in two groups was lower than 100 ng/L before administration. At the end of follow-up, the plasma BNP changed slightly in study group, but increased in control group, and the plasma BNP in control group was higher than that in study group [ （ 105.67 ± 15.64） ng/L vs. （73.23 ± 10.56） ng/L ], and there was significant difference （P 〈 0.05 ）. LVEF and CI was stable within the normal range before administration and at the end of follow-up in study group [（58 ± 4）% vs. （ 59±5）% ,（3.58±0.32） L/（min·m^2） vs. （3.56±0.26） L/（min·m^2） ]. LVEF and Clat the end of follow-up in control group was decreased compared with that before administration[ （49 ± 3 ）% vs.（56 ± 3 ）% , （ 2.97 ± 0.26 ） L/（ min＂ m2） vs. （3.62 ± 0.29 ） L/（min·m^2） 1, which was lower than that in study group[ （49 ± 3 ）% vs. （59 ± 5）%, （2.97 ± 0.26） L/（min-m2） vs. （3.56 ± 0.26） L/（min·m^2） 1, and there was significant difference（P 〈 0.05 ）. Conelttsions Telmisartan can delay the increase of the plasma BNP in patients with permanent cardiac pacing, delay the onset of symptoms of heart failure, and improve the quality of life. So early administration of telmisartan is recommended for the patients with permanent cardiac pacing.
出处
《中国医师进修杂志》
2014年第13期8-10,共3页
Chinese Journal of Postgraduates of Medicine
关键词
利钠肽
脑
心脏起搏
人工
替米沙坦
Natriuretic peptide,brain
Cardiac pacing,artificial
Telmisartan
