福辛普利联合缬沙坦对慢性心力衰竭患者血浆脑钠素及心功能的影响

目的探讨慢性心力衰竭（CHF）患者在用福辛普利治疗基础上加用缬沙坦治疗24周后脑钠素（BNP）水平的变化及对心功能的疗效。方法已接受常规治疗基础上，将CHF患者84例随机分为2组：联合用药组给予福辛普利10mg·d-1缬沙坦80mg·d-1，对照组给予福辛普利10mg·d-1。治疗观察时间均为24周．检测治疗前后两组患者的血压、血浆BNP水平、超声心动图等指标。结果治疗24周后，联合用药组、对照组治疗后两组间血压、血浆BNP浓度、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）和左室射血分数（LVEF）比较差异有统计学意义（均P〈0．05），两组治疗前后，患者血浆BNP降低值与LVEDD、LVESD减少呈正相关，而与LVEF的增加呈负相关。结论联合应用福辛普利与缬沙坦能更好地改善预后，阻滞心室重建、降低血浆BNP水平，其临床疗效更佳。血浆BNP水平可以反映心力衰竭严重程度、作为治疗心力衰竭的监测指标之一。

Efficacy of fosinopril plus valsartn on plasma BNP and cadiac function of CHF patients

Aim To explore the efficacy of fosinopril plus valsartn on plasma BNP and cadiac function of CHF patients 24 weeks after the treatment. Method On the basis of conventional treatment,84 cases were divided randomly into 2 groups, the experimental group given fosinopril 10 mg ·d-1 plus vatsartn 80 mg·d-1 ,the control group fosinopril 10 mg ·d-1. Treatment duration was 24 weeks. Blood pres- sure, plasma BNP and echocardiography were tested before and after the treatment. Results 24 weeks after the treatment, there were sta- tistically differences in blood pressure, plasma BNP concentration, LVEDD, LVESD and LVEF between the two groups （ P 〈 0.05 ）. In both groups, the decrease in BNP was positively correlated with the decrease in LVEDD and LVESD, and negatively correlated with the increase in LVEF. Conclusions Fosinopril plus valsartn can effectively improve the prognosis of patients, block ventricular reconstruc- tion, decrease plasma BNP levels so as to achieve a better efficacy. Plasma BNP levels can indicate the severity of heart failure and be used as a monitoring indicator for treating heart failure.