缬沙坦联合卡维地洛对慢性心力衰竭患者脑钠肽水平及心功能的影响

Effect of valsartan combined with carvedilol on brain natriuretic peptide level and cardiac function in patients with chronic heart failure

目的探讨缬沙坦与卡维地洛联用对慢性充血性心力衰竭患者血清氨基末端脑钠尿肽原（NT—proB—NP）水平及左心功能的影响。方法将96例慢性心力衰竭住院患者随机分为观察组和对照组，每组48例，两组患者均给予常规抗心力衰竭治疗，观察组在此基础上加用缬沙坦与卡维地洛，治疗6个月后比较两组患者治疗前后血清NT－proBNP水平、左心功能变化及治疗过程中不良反应发生情况。结果两组治疗前血清NT—proBNP水平比较差异未见统计学意义（P〉0．05），治疗后血清NT—proBNP水平均较治疗前明显降低，观察组血清NT—proBNP水平降低程度更为明显，组间比较差异有统计学意义（P〈0．05）；两组治疗后左心室舒张末内径、左心室收缩末内径均较治疗前降低，左心室射血分数、心搏出量升高，观察组左心功能改善情况优于对照组，组间比较差异有统计学意义（P〈0．05）。结论缬沙坦联合卡维地洛治疗慢性心力衰竭可明显降低患者血清NT-proBNP水平，有效改善左心功能，无明显不良反应发生，临床应用安全、有效。

Objective To investigate the effect of valsartan combined with carvedilol on serum NT-proBNP level and left heart function in the patients with chronic congestive heart-failure. Methods Ninety-six inpatients with chronic congestive heart-failure were ranolomly divided into observation group and control group, each group with 48 cases. Both groups were treated with routine heart failure treat- ment, the observation group was given carvedilol on the basis of routine heart failure treatment, the treatment course was 6 months. The serum NT-proBNP level, the change of left heart function and adverse reactions in the two groups before and after the treatment were compared. Results The serum NT-proBNP level between the two groups had no significant difference （ P 〉 0.05 ） before the treatment, well after the treatment, the serum NT-proBNP levels of the two groups decreased obviously and the serum NT-proBNP level of the patients in the observation group decreased more obviously, there was significant difference between the two groups （ P 〈 0.05 ）. The LVEDD and LVSDD of the patients in the two groups decreased, the LVEF and SV increased in the two groups after the treatment. The improvement effect of left heart function in the observation group was better than that in control group, there was significant difference between the two groups（P 〈 0.05 ）. Conclusions Valsartan combined with carvedilol in treating chronic cardiac failure can decrease the serum NT-proBNP level of the patients obviously and improve their left heart function effectively ,without obviously adverse reaction, so it is safe and effective.