厄贝沙坦、倍他乐克对慢性心衰患者血清BNP及心功能的影响

Effects of Irbesartan and Metoprolol on plasma level of brain natriuretic peptide and cardiac function in patients with chronic heart failure

目的探讨BNP与心衰患者心功能的关系,并比较厄贝沙坦、倍他乐克对心衰患者BNP、LVEF的影响。方法选取不同程度慢性收缩心衰患者46例,随机分为倍他乐克组(23例)和厄贝沙坦组(23例),两组均加用ACE I,利尿剂或地戈辛,治疗前及治疗6月后检测BNP、LVEF。结果心衰患者心功能程度与LVEF、BNP显著相关,倍他乐克、厄贝沙坦治疗后BNP显著下降,LVEF显著升高,仅倍他乐克、厄贝沙坦对LVEF治后不同。结论倍它乐克、厄贝沙坦均能改善患者心功能,对心功能改善无明现差异。

To investigate the correlations between the left ventricular function and plasma levels of B-type natriuretic peptides （BNP）, and to compare the efficacy of Irbesartan and Metoprolol on the plasma levels of BNP and left ventricular function in patients with chronic heart failure （CHF）. Methods A total of 46 patients with CHF,who had already received conventional therapy,were randomly divided into two groups; the Metoprolol group （n = 23） and the Irbesartan group （n= 23）. Patients in the Metoprolol group were given Metoprolol titrated to the target dosage （from 6.25mg bid to 50 mg bid）. Plasma BNP levels and left ventricular function were analysed before and 6 months after treatment. Results The left ventricular function was correlated with plasma levels of BNP. After treatment with Metoprolol or Irbesartan, plasma BNP levels were reduced （581.63 ng/L±164.19 ng/L vs 264.51 ng/L±120. 67 ng/ L, 619.16 ng/L±170. 35 ng/L vs 325.37 ng/L±201.62 ng/L, P〈0. 05）; while left ventricular function was enhanced （37.61±4.34% vs 48.64±5.21%,35.21±4.43 vs 43.15±6.14%, P〈0.05）. However, when compared with Metoprolol group, the changes of BNP and left ventricular function failed to show significant difference in Irbesartan group（P〉0. 05）. Conclusion Both Metoprolol and Irbesartan can improve the left ventricular function in patients with chronic heart failure.