厄贝沙坦对维持性血液透析合并心力衰竭患者左室重构的影响

The effect of irbesartan on left ventricle remodeling of maintenance hemodialysis patients with heart failure

目的观察厄贝沙坦对维持性血液透析合并心力衰竭患者心室重构及心功能的影响。方法收集维持性血液透析合并心力衰竭患者52例,随机分为2组,治疗组27例采用厄贝沙坦加常规治疗,对照组25例采用常规治疗。超声心动图测定2组患者治疗前后左室质量指数(LVMI)、心肌活动指数(Tei)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心输出量(CO)的变化,ELISA方法检测血浆脑钠肽(BNP)及血管紧张素Ⅱ(AngⅡ)的表达水平,全自动生化分析仪检测血清尿素氮(BUN)、肌酐(Scr)及钾离子(K^+)的变化。结果与治疗前比较,2组治疗后LVEDD、LVMI、Tei指数、BNP和AngⅡ均明显下降(P<0.05),LVEF及CO均明显增加(P<0.05),且与对照组治疗后比较,治疗组改善更显著(P<0.05),2组治疗前后血BUN、Scr及K^+均无明显变化(P>0.05)。结论厄贝沙坦具有改善维持性血液透析合并心力衰竭患者左室重构及心功能的作用,且较为安全。

Objective To observe the effect of irbesartan on maintenance hemodialysis patients complicated with heart failure ventricular remodeling and heart function influence. Methods Collected data of maintenance hemodialysis pa- tients complicated with heart failure in 52 cases, they were randomly divided into two groups, the treatment group of 27 cases by using irbesartan add routine treatment, 25 cases in the control group using conventional treatment. Ultrasonic cardiogram was measured in the two groups before and after treatment with left ventricular mass index （LVMI）, cardiac index （Tei）, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVEDD） and cardiac output （CO） changes, ELISA method for the detection of plasma brain natriuretic peptide （BNP） and angiotensin II （Ang II） expression level, Detection of blood urea nitrogen （ BUN）, serum creatinine （Scr） and potassium （ K ＋ ） changes. Results Compared with those before treatment, LVEDD, LVMI, Tel, BNP and Ang II were significantly decreased （ P 〈 0.05）, LVEF and CO were sig nificantly increased （ P 〈 0.05 ）in both groups, the improvement in treatment group was better than control group, the differ- ence was statistically significant（ P 〈 0.05 ） ; serum BUN, Scr and serum K ＋ had no obvious change, no statistical signifi- cance differences were found （ P 〉 0.05）. Conclusion Irbesartan has improved cardiac function in maintenance hemodialy- sis patients with heart failure and left ventricular remodeling and it was relatively safe.