福辛普利和氨氯地平对高血压患者血浆NT-proBNP的影响

Impact of fosinopril and amlodipine on the concentration of plasma NT-proBNP in patients with hypertensive left ventricular hypertrophy and diastolic dysfunction

目的:观察福辛普利及氨氯地平降压治疗对高血压左室肥厚(LVH)、舒张功能及血浆氨基末端脑钠素前体(NT-proBNP)浓度的影响。方法:选择高血压病伴LVH及舒张功能不全患者68例,随机分为两组:福辛普利组(34例),氨氯地平组(34例),总疗程6个月。以多普勒超声心动图观察治疗前、后LVH和舒张功能的改变情况。利用酶联免疫法测定治疗前后血浆NT-proBNP的浓度。结果:治疗后福辛普利组室间隔厚度(IVSD)、左室后壁厚度(LVPWD)、左室质量指数(LVMI)及NT-proBNP的浓度均显著低于氨氯地平组(P<0.05)。两组间E/A的比较无显著差异(P>0.05)。结论:福辛普利降低LVH及血浆NT-proBNP的作用强于氨氯地平。血浆NT-proBNP的浓度随着LVH和舒张功能不全的减轻而降低,故测定血浆NT-proBNP的浓度可能是临床评价减轻心室肥厚和改善心舒张功能不全的敏感指标之一。

Objective： To observe the impacts of fosinopril and amlodipine on left ventrieular hypertrophy, diastolic function and concentration of plasma NT--proBNP. Methods： The 68 patients with hypertensive left ventricular hypertrophy and diastolic dysfunction were chosen, and randomly divided into two groups： Fosinopril group and amlodipine group, with a total course of treatment for 6 months. The changes in the left ventricular hypertrophy and diastolic function detected by Doppler echocardiography before and after treatment. The concentrations of plasma NT-- proBNP before and after treatment were assayed using ELISA method. Results： The levels of IVSD, LVPWD, LV- MI and NT--proBNP of fosinopril group were lower than those of amlodipine treatment group （P〈0. 05 all）. There was no statistical difference in the E/A value between two groups （P〉0.05）. Conclusion： The effects of fosinopril on decrease LVH and plasma NT-- proBNP concentrations are stronger than those of amlodipine in patients with LVH and diastolic dysfunction; It can be deduced that the concentration of plasma NT--proBNP is a sensitive index for evaluating its clinical effects.