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

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。

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

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.