厄贝沙坦对慢性心力衰竭和心肌纤维化的影响研究

目的 探讨厄贝沙坦对心力衰竭患者心功能和心肌纤维化的影响.方法 选择心力衰竭患者（NYHA分级为Ⅱ～Ⅳ级）100例,随机分为常规治疗组和厄贝沙坦组.每组50例;在治疗前和治疗后12周应用心脏彩色超声测定心功能变化（测量LVEF）,采用放射免疫法检测血浆脑钠肽（BNP）、血清Ⅲ型前胶原氨基末端肽（PⅢNP）和透明质酸（HA）的浓度.结果 ①厄贝沙坦组BNP、PⅢNP和HA治疗后比常规治疗组治疗后降低效果更明显（P＜0.05）;两组患者LVEF值治疗后比治疗前明显升高（P＜0.01）,而且厄贝沙坦组治疗后与常规治疗组治疗后相比升高明显（P＜0.05）.②血清PⅢNP、HA与BNP值呈正相关,血清PⅢNP、HA与LVEF值呈负相关.结论 在常规治疗慢性心衰的基础上加用厄贝沙坦更能有效地抑制心脏HA和Ⅲ型胶原的产生,可以起到抗心肌纤维化、改善心功能的作用.

The impact of Irbesartan in chronic heart failure and myocardial fibrosis

Objective To investigate the effects of irbesartan in patients with heart failure on cardiac function and myocardial fibrosis. Methods 100 patients with heart failure （NYHA classification was grade Ⅱ- Ⅳ ） were randomly divided into conventional treatment group and irbesartan group （n=50）. Cardiac function （LVEF） was determined by echocardiogram before and after 12 weeks treatment. Concentrations of brain natriuretic peptide （BNP）, serum amino-terminal procollagen m peptide （PⅢNP） and hyaluronic acid （HA） were measured by radioimmunoassay. Results （1）In Irbesartan group, the levels of BNP, P Ⅲ NP and HA were significantly decreased than the conventional treatment group（P〈0.05 ）, LVEF values of two groups were significantly improved af- ter treatment （P〈0.01）, and improvement degree was significant in irbesartan group （P〈0.05）. （2）Serum PⅢNP and HA were positively associated with the BNP, serum PⅢNP and HA was negatively associated with LVEF. Conclusion The conventional treatment of chronic heart failure based on the use of irbesartan inhibited the heart of HA and collagen m production more effectively, and may inhibit the myocardial fibrosis and improve cardiac function.