坎地沙坦对不稳定心绞痛患者脑钠肽、白介素-6和C-反应蛋白水平的影响

目的:探讨Ang受体拮抗剂-坎地沙坦对不稳定心绞痛(UAP)患者血浆脑钠肽(BNP)、白介素-6(IL-6)和C-反应蛋白(CRP)水平的影响,并了解BNP是否与炎症反应有关。方法:选取UAP患者90例随机分为常规治疗组和坎地沙坦治疗组。常规治疗组(n=40)采用不稳定心绞痛常规治疗,坎地沙坦治疗组(n=50)在常规治疗基础上加用坎地沙坦酯片治疗8周。观察入院即刻、1周及8周血清BNP、IL-6、CRP水平、心脏超声指标的变化。结果:UAP组患者BNP、IL-6及CRP水平明显高于正常对照组(P<0.01)。常规治疗组和坎地沙坦治疗组治疗1周后,上述指标与治疗前相比均有下降(P<0.05),治疗8周后坎地沙坦组这种改变更加显著(P<0.01)。两组之间治疗8周的比较,上述指标以及LVED、E/A、LVPWT、IVST均有显著性差异。BNP与IL-6、CRP及LVED存在正相关。结论:UAP患者坎地沙坦组治疗后BNP早期的下降与IL-6、CRP的下降有关,而后期的下降还与LVED有关。在常规治疗的基础上加用坎地沙坦可明显降低UAP及ACS血清炎症因子水平,稳定AS斑块。

The effects of candesartan on plasma levels of brain natriuretic peptide,IL-6 and C-reactive protein in patients with unstable angina pectoris

Objective:To study the treatment effect of Candesartan in patients with Unstable Angina Pectoris on plasma levels of BNP、IL-6、CRP and to explore the relation of BNP and inflammation reaction.Methods:90 patients with Unstable Angina Pectoris were treated randomly with routine therapy(n=40)and with routine therapy plus Candesartan 4-8mg/d(n=50)for 8 weeks.Before and after 1 weeks、8 weeks of the therapy,the changes of BNP、IL-6、CRP and some cardiac Ultrasound index were measured.Results:The level of BNP、IL-6 and CRP were obviously higher in patients with UAP than that in normal controls(P<0.01).After 1 weeks the levels of BNP、IL-6 and CRP in routine therapy group and Candesartan treatment group were decreased than those before treatment(P <0.05)but after 8 weeks of the therapy,BNP、IL-6 and CRP were significantly decreased in Candesartan treatment group compared with those in the control group(P <0.01).After 8 weeks the levels of BNP、IL-6、CRP and LVED、E/A、LVPWT、IVST were significantly changed between routine and Candesartan therapy groups.BNP was positively correlated with IL-6、CRP and LVED.Conclusion:The reduction of BNP is related to the changes of IL-6、CRP and LVED.On the basic of general treatment,using of the Candesartan may lower the serum inflammatory factor level in UAP,and improve stability of atherosclerosis plaque.