替米沙坦对轻度心力衰竭心肌纤维化和心功能的影响

Effects of telmisartan on myocardial fibrosis and left ventricular function in patients with mild heart failure

目的探讨替米沙坦对轻度心力衰竭心肌纤维化和心功能的影响。方法选择轻度心力衰竭患者(NYHA分级为Ⅰ～Ⅱ级)72例为观察组,随机分为常规治疗组和替米沙坦组,每组36例;另选健康体检者30例为对照组,治疗前和治疗3个月时采用放射免疫法测定血清Ⅲ型前胶原氨基末端肽(PⅢNP)和血浆脑钠肽(BNP)浓度,并应用心脏彩声超声测定心功能变化。结果观察组血清PⅢNP和血浆BNP浓度均高于正常对照组(P<0.01);3个月后与治疗前比较:替米沙坦组血PⅢNP和BNP均明显下降(P<0.01);且较常规治疗组亦明显下降(P<0.05)。结论替米沙坦治疗轻度心力衰竭患者可以起到抗心肌纤维化、改善心功能的作用。

Objective To evaluate the effects of telmisartan on myocardial fibrosis and left ventricular function in patients with mild chronic heart failure.Methods The 72 patients were randomly divided into two groups,routine treatment group （n=36） and telmisartan group （n=36）,and 30 healthy subjects were enrolled as control group.The serum levels of aminoterminal propeptide of typeⅢ procollagen（PⅢNP）and brain natriuretic peptide （BNP）were detected by radioimmunoassay.After 3-month therapy,PⅢNP and BNP were rechecked and the parameters of ventricular function were detected by echocardiography.Results The serum levels of PⅢNP and BNP in routine treatment group and telmisartan group were significantly higher than those of control group （P0.01）.After 3-month treatment,the levels of PⅢNP and BNP were significantly decreased in telmisartan group,as compared with those before treatment （P0.01）,which were also significantly lower than those of routine treatment group（P0.05）.Conclusion The telmisartan therapy can relieve myocardial fibrosis and improve left ventricular function in old patients with mild heart failure.