NT-proBNP指导下调整苯那普利剂量对慢性心衰的影响

Effect of Dose Adjustment of Benazepril Guided by NT-proBNP on Chronic Heart Failure

[目的]探讨在心衰常规治疗基础上根据N末端B型脑钠肽前体（NT-proBNP）数值调整苯那普利剂量与以患者临床症状调整苯那普利靶剂量对慢性心衰治疗效果的影响.[方法]90例慢性心衰患者在常规治疗心衰基础上,分为两组：NT-proBNP指导组（A组）和症状指导组（B组）,A组以组中NT-proBNP水平中位数为目标,以NT-proBNP〈300 pg/L为最终目标调整剂量,B组以传统症状调整药物至靶剂量,15个月后复查NT-proBNP以及对其再住院率进行对比.[结果]治疗后A组所测得NT-proBNP数值较B组明显下降,A组再住院率亦比B组低,且两组相比较差异有明显统计学意义（P〈0.05）.[结论]以NT-proBNP水平指导下调整苯那普利剂量比传统的根据患者症状调整苯那普利至靶剂量更具有客观性,对改善慢性心衰以及减少再住院率均有明显效果.

[Objective]To explore the effects of dose adjustment of benazepril according to brain natriuretic peptide（NT-proBNP） value or clinical symptoms based on the routine treatment on the therapedtic efficacy of chronic heart failure. [Methods] Based on the conventional treatment of heart failure, 90 patients with chronic heart failure were divided into＇ NT proBNP guided group（group A） and symptom-guided group（group B）. In group A, the median of NT-proBNP was the target, and NT-proBNP 〈300pg/L was the ultimate adjustment dose of benazepril. In group B, the dose of benazepril was adjusted by clinical symptoms. After 15 months, NT-proBNP was reexamined and the readmission rate was compared between two groups. [Results] Compared with group B, the value of NT-proBNP in group A decreased. The readmission rate of group A was lower than that of group B, and there was significant difference between two groups（ P 〈0.05）. [Conclusion]Adjusting the dose of benazepril according to the level of NT proBNP is more objective than that according to clinical symptoms, and has obvious effect for improving chronic heart failure and decreasing the readmission rate.