环磷腺苷葡胺联合美托洛尔对慢性心功能不全患者心功能及BNP的影响

Effects of meglumine adenosine cyclophosphate in combination with metoprolol on the level of brain natriuretic peptide and the cardiac function of patients with chronic heart failure

目的观察环磷腺苷葡胺联合美托洛尔对慢性心功能不全患者心功能及血浆B型脑钠肽(BNP)的影响。方法选择充血性心力衰竭(CHF)患者100例,随机分为治疗组与对照组,每组50例。对照组予以吸氧、洋地黄、利尿剂、血管紧张素转换酶抑制剂、硝酸酯类等药物常规抗心衰治疗;治疗组在对照组基础上给予环磷腺苷葡胺注射液120mg静脉滴注,每天1次,美托洛尔25mg,口服,每天2次;疗程均为2周。治疗前后两组均测定左室射血分数、血浆BNP浓度。观察治疗前后两组心功能和血浆B型脑钠肽的变化和差异。结果治疗组对心力衰竭的临床疗效优于对照组(P<0.05);两组患者治疗后血浆B型脑钠肽水平较治疗前均明显下降,治疗组浓度差明显大于对照组(P<0.05),治疗组左心室射血分数(LVEF)差值也同样高于对照组。结论慢性心力衰竭患者在常规治疗基础上加用环磷腺苷葡胺联合美托洛尔治疗可进一步改善心功能,降低血浆B型脑钠肽水平。

Objective To investigate the effect of meglumine adenosine cyclophosphate in combination with metoprolol on the level of brain natriuretic peptide（BNP）and the cardiac function of the patients with chronic heart failure.Methods 100 patients with CHF were randomly divided into treatment and control.50 cases in the treatment group were given meglumine adenosine cyclophosphate intravenous drip at 120 mg per day;metoprolol orally at 25 mg,twice a day;and oxygen,digitalis,diuretics,angiotensin converting enzyme inhibitors,nitrates and other anti-heart failure drugs for14 days.The control group were given oxygen,digitalis,diuretics,angiotensin converting enzyme inhibitors,nitrates and other anti-heart failure drugs in two weeks.Both groups were measured left ventricular ejection fraction and plasma BNP concentration before and after the treatment.The changes and differences of cardiac function and plasma B-type brain natriuretic peptide were observed in the two groups before and after treatment.Results The clinical effect of the cardiac failure in the treatment group was better than that of the control group（P〈0.05）.In both groups,blood levels of B-type natriuretic peptide were significantly decreased after the treatment.Nevertheless,the concentrationa difference of BNP and of LVEF of the treatment group is bigger than that of the control group（P〈0.05）.Conclusion It proves that adding in meglumine adenosine cyclophosphate and metoprolol in the conventional therapy could further improve cardiac function and reduce the BNP level.