长期口服缬沙坦对慢性心力衰竭患者血浆和肽素水平的影响

Effect of long-term oral valsartan on the plasma copeptin levels of patients with chronic heart failure

目的:观察慢性心力衰竭患者缬沙坦治疗前后血浆和肽素的变化,探讨缬沙坦抑制心室重构的作用机制。方法:2012年1月-2013年12月收治慢性心衰患者100例,随机分为两组。治疗组给予缬沙坦治疗,对照组给予常规治疗,观察两组治疗后血浆和肽素水平。结果:两组患者治疗1个月与治疗前、治疗8个月与1个月比较,血浆和肽素水平均下降,差异均有统计学意义(P<0.05或P<0.01)。治疗组患者治疗1个月、8个月的血浆和肽素水平与同时间段对照组相比均下降,差异均有统计学意义(P<0.05或P<0.01)。治疗1个月,两组患者左室射血分数(LVEF)、左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)与治疗前比较,以及两组间比较,差异均无统计学意义(P>0.05)。治疗6个月,治疗组LUEF较对照组明显升高(P<0.01),LVESD及LVEDD较对照组明显减小(P<0.01)。结论:缬沙坦能够抑制慢性心衰患者血浆和肽素的分泌,抑制神经内分泌因子,抑制心室重构,改善心功能。

Objective:To observe the changes of plasma copeptin levels of patients with chronic heart failure before and after the treatment of valsartan and study the effect mechanism of valsartan inhibit ventricular remodeling.Methods:100 cases of patients with chronic heart failure from January 2012 to December 2013 were randomly divided into two groups.The treatment group were given valsartan treatment and the control group were given conventional treatment,the plasma copeptin levels of the two groups after treatment were observed.Results:The plasma copeptin levels of the two groups decreased after 1 months of treatment compared with before treatment,8 months of treatment compared with 1 month of treatment,the differences had statistical significance(P<0.05 or P<0.01).The plasma copeptin levels of the treatment group decreased after 1 months of treatment,8months of treatment compared with the same time of the control group,the differences had statistical significance(P<0.05 or P<0.01).There were no statistically significant difference of the left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end-diastolic diameter(LVEDD) of the patients in two groups between after 1 month of treatment and before treatment,and there were no statistically significant difference between the two groups(P>0.05).Treatment for 6 months,the LUEF of the treatment group was obviously higher than that of the control group(P<0.01),the LVESD and LVEDD reduced significantly than the control group(P<0.01).Conclusion:Valsartan could inhibit the plasma copeptin secretion of patients with chronic heart failure and the neuroendocrine factor,inhibit ventricular remodeling and improve cardiac function.