慢性心力衰竭患者血浆脑钠肽浓度的变及坎地沙坦对其干预的研究

目的 观察慢性心力衰竭患者血浆脑钠肽浓度的变化及坎地沙坦对其水平的影响.方法 ①选择心衰组76例,按NYHA心功能分级为Ⅱ级18例、Ⅲ级16例、Ⅳ级42例;对照组80例,比较两组间血浆脑钠肽的变化.②将心衰患者按左心室射血分数分成A组（＜50％组）和B组（≥50％组）,比较两组血浆脑钠肽值.③将42例Ⅳ级心功能患者在常规抗心衰治疗的基础上给予坎地沙坦治疗,12周后观察血浆脑钠肽浓度变化.结果 ①血浆脑钠肽在心功能正常组和NYHA心功能Ⅱ级组、Ⅲ级组、Ⅳ级组之间两两比较差异均有统计学意义（P＜0.05）.②左心室射血分数＜50％组的血浆脑钠肽水平与左心室射血分数≥50％组比较有明显增高（P＜0.01）.③坎地沙坦治疗组治疗前与治疗12周后比较,血浆脑钠肽水平均有显著下降（P＜0.01）.结论 慢性心力衰竭患者血浆BNP浓度均显著增高,并随心功能级别的增高、左室射血分数的下降水平明显增高.坎地沙坦能显著降低严重心衰患者的血浆BNP水平,改善心功能.

The clinical study of the plasma BNP level in patient with chronic heart failure and the effect of candesartan

Objective To study the change of blood plasma BNP concentrations in patients with chronic heart failure and the effect of candesartan. Methods （1）According to the New York Heart Association（NYHA） classification and the left ventricular ejection fraction, 76 patients with heart failure were divided into different heart function groups,group A（LVEF〈50% ） and group B（LVEF ~〉 50% ）, and so on. The plasma brain natriuretic peptide （BNP） concentrations were determined by ELISA. （2）The patients with class IV heart function were given same routine treatment, then the candesartan were added. After 12 weeks treatment, the change of BNP concen- trations were determined. Results （1）Plasma BNP was significantly different among all groups （P〈0.05）. （2）Com- pared to the left ventricular ejection fraction 〈50% group, BNP was significantly lower in the left ventricular ejec- tion fraction 〉50% group （P〈0.01）. （3）After 12 weeks treatment, BNP significantly decreased in the treatment group of candesartan（P〈0.01 ）. Conclusion BNP concentrations was significantly increase in patients with chronic heart failure, especial in patients with worse heart function and decreased left ventricular ejection fraction. Can- desartan can improve heart function and decrease the plasma BNP concentrations.