血管紧张素转换酶抑制剂对老年心力衰竭患者血浆脑钠肽水平的影响

目的：探讨不同剂量的血管紧张素转化酶抑制剂（培哚普利）对老年慢性心衰患者脑钠肽的影响。方法：将60名老年心衰患者随机分为较小剂量组（每天4mg）和较大剂量组（8mg），治疗8周，测定治疗前、后BNP浓度，血压、肌酐、LVEDD、LVEF，观察治疗前后各项指标变化及组间差异。结果：老年心衰患者血浆中BNP浓度随（NYHA）分级增高而升高，与LVEF呈负相关，与LVEDD呈正相关，较大剂量组比较小剂量组更能明显降低血浆中BNP。结论：心衰时血浆BNP与心衰严重程度密切相关，大剂量培哚普利可明显降低BNP，改善心功能，且患者耐受性良好。

The effection of angiotensin-converting enzyme inhibition to brain natriuretic peptide in elderly patients with heart failure

Objective:To explore the effect of different does of angiotensin-converting enzyme inhibition(Perindopril) to brain natriuretic peptide(BNP) of heart failure in elderly patients.Methods:To divide 60 elderly patients of heart failure into two groups at random,the group of smaller doses(4 mg every day) and larger does(8 mg every day) with 8 weeks treatment,to measure the BNP concentration,blood pressure,creatinine,LVEDD,LVEF before and after treatment,and observe the changes of each index and differences between two groups before and after treatment.Results:BNP concentration in elderly patients'plasma of heart failure increases with NYHA classification growth,had negative correlation with LVEF and positive correlation with LVEDD,the BNP concentrations in the group of larger doses were apparently lower than those in the other group.Conclusion:Plasma BNP correlates closely to the severity level of heart failure.The larger doses of perindopril can apparently lower BNP and to perindopril improve heart function.The patients have good toleration.