缬沙坦对心力衰竭患者血浆脑钠肽前体及左室舒张功能的影响

目的探讨缬沙坦对严重心力衰竭患者血浆脑钠肽前体（NT-proBNP）水平及左室舒张功能的影响。方法心功能Ⅳ级的心力衰竭患者86例,随机分为两组,常规治疗组（对照组）43例,缬沙坦组（观察组）43例,在常规抗心力衰竭治疗的基础上,给予缬沙坦治疗,6个月后,观察血浆NT-proBNP水平变化及超声心动图各项指标,并进行比较。结果两组患者治疗6个月后血浆NT-proBNP水平均较治疗前显著降低（P〈0.05）,但观察组降幅比对照组明显,差异有统计学意义（P〈0.05）。两组患者左心室质量指数（LVMI）、左室等容舒张时间（IVRT）均较治疗前降低、缩短（P〈0.05）,舒张早期和晚期最大速度比值（E/A）均较治疗前显著升高（P〈0.05）,观察组治疗后LVMI,IVRT及E/A比值改善程度比对照组更显著,差异有统计学意义。结论缬沙坦能显著降低严重心力衰竭患者的血浆脑钠肽前体水平,能明显改善左室肥厚及舒张功能。

Effect of valsartan on plasma N-terminal-pro-brain natriuretic peptide and left ventricular diastolic function in heart failure patients

Objective To explore the effect of valsartan on N-terminal-pro-brain natriuretic peptide （NT-proBNP） and left ventricular diastolic function in severe heart failure patients.Methods 86 patients with heart failure of grade IV were randomly divided into two groups,routine treatment group （control group,n=43） and valsartan group （experimental group,n=43） to receive treatment of valsartan on the basis of routine treatment.The changing of the levels of NT-proBNP and the indexes of echocardiogram were observed after six months treatment and made comparison.Results After six months of treatment,the levels of plasma NT-proBNP of both groups decreased obviously （P0.05）.There were statistic differences between controlled group and experimental group in term of level of NT-proBNP （P0.05）.The LMVI and the IVRT dropped obviously （P0.05）.The ratio of E/A raised significantly （P0.05）.The LMVI,the IVRT and the ratio of E/A of the experimental group improved significantly （P0.05）.And there were statistic differences in comparison with those of the control group.Conclusion Valsartan can significantly reduce the level of NT-proBNP of severe heart failure patients and improve the hypertrophy and diastolic functions of left ventricles.