培哚普利对慢性心力衰竭患者血清CTn-I的影响

The effects and clinical significance of perindopril on serum cardiac troponin I in patients with chronic heart failure

目的 观察慢性心力衰竭患者血清肌钙蛋白I（cardiac troponi I,CTn-I）水平及其与左室射血分数（left ven-tricular ejection fraction,LVEF）的相关性和培哚普利对它的影响及临床意义。方法 （1）64例慢性心力衰竭患者,男42例,女22例,均对治疗方案知情同意。根据纽约心脏协会心功能分级标准,心功能Ⅲ级45例,心功能Ⅳ级19例。随机将入选患者分为两组,常规治疗组32例和培哚普利组32例。选择同期本院门诊健康体检者30例为对照组,男19例,女11例;（2）常规治疗组接受心力衰竭的常规治疗,培哚普利组在常规治疗的基础上加用培哚普利2～6 mg,治疗随访6周。（3）采用电化学免疫发光法测定血清CTn-I水平,应用彩色心脏超声仪测定心功能指标左室射血分数LVEF,两组比较、且与健康对照组比较,并进行组间均数t检验及相关性分析分析。结果 血清CTn-I水平心力衰竭患者明显高于对照组（P〈0.01）,升高的程度随着心功能的恶化而明显,常规治疗组及培哚普利组治疗后血清CTn-I水平均显著降低（P〈0.05）,而培哚普利降低更明显（P〈0.01）,左室射血分数两组治疗后均较治疗前升高,以培哚普利组升高幅度更明显（P〈0.01）。结论 血清CTn-I与心力衰竭的发生发展有关,培哚普利可降低血清CTn-I水平,改善心功能,培哚普利有抑制心肌损伤,改善心室重塑作用。

Objective To investigate the level of serum cardiac troponin I （CTn-I） and it＇s correlation with left ventricular ejection fraction （LVEF） in patients with chronic heart failure , and to observe the effect of perindopril on the CTn-I and LVEF. Methods （ 1 ） Sixty-four patients with heart failure including 42 males and 22 females were selected. And all patients knew and agreed the items. According to the grade of cardiac function standard of New York Heart Association, 45 patients were of grade Ⅲ, 19 patients grade Ⅳ. They were randomly divided into two groups, the routine treatment group （n = 32） and the perindopril treatment group （ n = 32）. Another 30 healthy examiners at the same time in the clinic were selected as control group, including 19 males and 11 females. （2） Patients in routine treatment group received routine treatment. Patients in the perindopril treatment group received perindopril 2 - 6 mg per day on the base of routine treatment, all the patients being followed up for 6 weeks. （3） Serum CTn-I was measured in 64 patients with CHF and 30 cases with no heart disease by chemical immunofluoresence and left ventricular ejection fraction was detected in both groups by echocardiography, and the average figures and correlative induces were analyzed by statistical method. Results Level of CTn-I was higher in patients with CHF than that in the control group （P 〈 0.01 ）, and the elevating degree was clearly related with the deterioration of cardiac function . In both treatment groups after treatment（P 〈 0.05）, more significant in perindopril treatment group （P 〈 0.01）. LVEF was higher in both groups after treatment than that before the treatment , more significant in the perindopril treatment group （P 〈 0.01 ）. Conclusion CTn-I and LVEF are related with the development of heart failure. Perindopril may decrease levels of CTn-I, help to improve the cardiac function and improve left ventricular remodeling.