缬沙坦联合依那普利治疗对慢性心力衰竭患者心功能及BNP水平的影响

Effect of valsartan combined with enalapril on heart function and BNP level in patients with chronic heart failure

目的探讨缬沙坦联合依那普利治疗对慢性心力衰竭患者心功能及BNP水平的影响。方法选取慢性心力衰竭患者90例,随机分为观察组和对照组各45例。两组患者均予以低盐饮食、吸氧、心电监护、强心、利尿、血管紧张素转换酶抑制等治疗;观察组患者在上述治疗的基础上联合应用缬沙坦治疗,疗程6个月。观察比较两组患者的临床疗效、治疗前后心功能指标LVEF、LVMI、LVEDV、IVSD、LVPWD、LVEDD以及BNP水平的变化情况。结果观察组患者的治疗总有效率(95.6%)显著高于对照组患者(77.8%),差异有统计学意义(P<0.05)。治疗6个月后,两组患者的LVEF显著升高,LVMI、LVEDV、IVSD、LVPWD、LVEDD显著降低,与治疗前比较差异有统计学意义(P<0.05);观察组患者的LVEF高于对照组患者,LVMI、LVEDV、IVSD、LVPWD、LVEDD低于对照组患者,差异有统计学意义(P<0.05或P<0.01)。治疗后两组患者的BNP水平均较治疗前显著降低(P<0.05);观察组患者降低程度更显著,与对照组患者比较差异有统计学意义(P<0.05)。结论缬沙坦联合依那普利治疗慢性心力衰竭患者疗效显著,可以显著改善患者的心功能,可能与其显著降低患者BNP水平有关,值得进一步研究和探索。

Objective To investigate the effect of valsartan combined with enalapril on cardiac function and BNP level in patients with chronic heart failure. Methods 90 hospitalized patients with chronic heart failure were selected and randomly divided into observation group and control group with 45 cases in each. Low-salt diet, oxygen, ECG monitor, cardiac, diuretic, and angiotensin converting enzyme inhibitor were carried out in both groups. On the basis of the above treatment, valsartan was added in the observation group. After 6 months of treatment, efficacy of the two groups as well as LVEF, LVMI, LVEDV, IVSD, LVPWD, LVEDD, and BNP levels before and after the treatment were compared. Results The total effect rate of the observation group （95.6%） was higher than that of the control group （77.8%）, which had significant difference （ P 〈 0.05 ）. After 6 months of treatment, level of LVEF increased and levels of LVMI, LVEDV, IVSD, LVPWD, and LVEDD decreased sharply in both groups compared with those before treatment, which had significant difference （P 〈 0.05 ）. Level LVEF in the observation group was higher than that in the control group, while levels of LVMI, LVEDV, IVSD, LVPWD, and LVEDD were lower than those in the control group （ P 〈 0.05 or P 〈 0.01 ） . BNP level in both groups was significantly lower compared with that before treatment （ P 〈 0.05 ） . Compared with the control group, BNP level in the observation group decreased more sharply, and there was significant difference in BNP level between the two groups （P 〈 0.05 ） . Conclusions Valsartan combined with enalapril for chronic heart failure has distinct outcomes and can greatly improve cardiac function, which might be related to the decrease of BNP level. Further researches are expected to focus on the relation between them.