缬沙坦对永久性心脏起搏患者血浆脑钠肽的影响

The Effect of Valsartan on Brain Natriuretic Peptide in the Pacemaker Population

目的研究应用缬沙坦对永久性心脏起搏患者血浆脑钠肽(BNP)浓度的影响,以了解ARB类药物对该类患者心功能的影响。方法入选2006年1月至2007年10月于我院行永久性心脏起搏的患者120例,其中VVI起搏62例DDD起搏58例,所有患者随机分为服用缬沙坦组(干预组)及未服用缬沙坦组(非干预组),每组根据起搏模式不同分为VVI起搏亚组及DDD起搏亚组,每个亚组以心室起搏百分比50%为界分为高起搏百分比组和低起搏百分比组。分别于服药前、服药后6个月检测血浆BNP浓度。结果干预组血浆BNP浓度显著低于与非干预组(P<0.05),缬沙坦对低起搏百分比患者的影响优于高起搏百分比患者(P<0.05),对DDD的影响优于VVI(P<0.05)。结论缬沙坦延缓永久性心脏起搏患者血浆BNP浓度的增加,延缓心衰症状的出现,提高生活质量。其中对低起搏百分比患者的影响优于高起搏百分比患者,对DDD的影响优于VVI。

Objective Investigate the effect of valsartan on the plasma concentration of brain natriuretic peptide （BNP） in the pacemaker population, so to know the effect of ACEI on the heart function in these patients. Methods 120 patients （ VVI 62, DDD 58） who were permanent cardiac pacing were enrolled from January 2006 to October 2007 in our hospital, all patients were randomized to two groups according to whether valsartan given or not, every group was divided to DDD subgroup and VVI subgroup, every subgroup was divided to high pacing percentage group and low pacing percentage group as the pacing percentage of 50 percent. The plasma concentrations of BNP were detected before taking medicine and 6 months after taking medicine. Results the plasma concentration of BNP in patients who take valsartan were significant lower than in patients who did not take valsartan（ P 〈 0.05） , the effect of valsartan on low pacing percentage group was higher significe than the pacing percentage group（ P 〈 0. 05）, the effect on DDD was superior to VVI （P 〈 0. 05）. Conclusion Valsartan can delay the increase of BNP in patients with permanent cardiac pacing, delay the appearance of the symptom of heart failure, improve the quality of life, the effect of. valsartan on low pacing percentage group was superior to high pacing percentage group, the effect on DDD was superior to VVI.