摘要
目的探讨比索洛尔对慢性心力衰竭(CHF)患者脑钠肽(BNP)水平和心功能的影响。方法86例CHF患者,纽约心脏病协会(NYHA)分级为Ⅱ-Ⅲ级,随机分为两组:治疗组(46例),对照组(40例)。治疗组在常规治疗基础上加用比索洛尔,从小剂量(1.25mg,qd)逐渐加至靶剂量(10mg,qd),治疗6个月。对比分析治疗前后两组患者的血浆BNP水平、NYHA分级、心率、血压、超声心动图等指标。结果治疗组较对照组左室舒张末期内径[(57±6)mmvs(65±5)mm]、左室收缩末期内径[(46±6)mmvs(54±4)mm]显著下降(P<0.01),左室射血分数(LVEF)显著升高[(49±7)%vs(38±8)%](P<0.01),血浆BNP[(261±60)vs(680±176)ng/L]水平显著降低(P<0.01)。而且,比索洛尔治疗前后患者血浆BNP降低值与LVEF的增加呈负相关。结论比索洛尔治疗CHF可使BNP值明显下降,缩小左室内径,增加LVEF,改善心功能。BNP水平与LVEF显负相关,可作为诊断心衰和了解预后的指标。
Objective To investigate the effects of Bisoprolol on changes in plasma brain natrinretic peptide （BNP） level and cardiac function in patients with chronic heart failure （CHF）. Methods A total of 86 patients with CHF were randomly divided into two groups： the Bisoprolol group （ n = 46） and the control group （ n = 40）. Patients in the Bisoprolol Group were given Bisoprolol titrated to the target dosage （from 1.25mg qd to 10mg qd）. Plasma BNP levels, NYHA functional class, heart rate, blood pressure, and echocardiographic indices were evaluated before and after 6 months therapy. Results After 6 - month therapy, Bisoprolol could significantly decrease left ventricular end - diastolic and - systolic dimensions [ LVEDd ： （57 ± 6 ） mm vs （65 ± 5 ） mm, LVESd ： （46 ± 6 ） mm vs （54 ± 4） mm ）, all P 〈 0. 01 ; increase left ventricular ejection fraction （ LVEF ： （49 ± 7 ） % vs （38 ± 8） %, P 〈 0.01 ）, and attenuated BNP （261 ± 60） vs （680 ± 176） ng/L, P 〈 0. 01 ], compared with the patients in the control group. Meanwhile, changes in BNP level were negatively correlated with the increase in LVEF （ r = - 0. 84, P 〈 0. 01 ）. Conclusion The value of BNP declined obviously after the use of Bisoprolol, which may reduce the left ventricular diameter, help to increase LVEF and improve the heart function. BNP level presented a negative correlation with LVEF,which can be used as index for diagnosis and prediction.
出处
《医药论坛杂志》
2008年第22期1-2,5,共3页
Journal of Medical Forum
关键词
慢性心力衰竭
比索洛尔
脑钠肽
Chronic Heart failure
Bisoprolol
Brain natriuretic peptide
