坎地沙坦治疗充血性心力衰竭的疗效及对内皮素和心钠素水平的影响  

Clinical Study of Candesartan in Patients With Congestive Heart Failure and Effects of Candesartan on Plasma Endothelin and Atrial Natriuretic Peptide

作　　者：王建刚[1] 严文广[1] 彭丽萍[1] 

机构地区：[1]中南大学湘雅三医院心血管内科,湖南长沙410013

出　　处：《实用预防医学》2007年第3期845-847,共3页Practical Preventive Medicine

摘　　要：目的研究一种新型血管紧张素Ⅱ(AngⅡ)受体拮抗剂(ARB)-坎地沙坦治疗充血性心力衰竭(CHF)的疗效以及对血浆内皮素(ET)和心钠素(ANP)水平的影响。方法50例CHF患者随机分为两组,对照组(n=25)用利尿剂和洋地黄治疗,坎地沙坦治疗组(n=25)在前者基础上加用坎地沙坦酯胶囊(4～8mg/d)治疗8周,观察治疗前后NYHA分级、血浆ET和ANP浓度的变化。结果经8周治疗后,坎地沙坦治疗组NYHA分级明显下降(P<0.01),并使血浆ET和ANP的水平明显降低(P<0.01),临床有效率优于对照组,但差异无显著性(P>0.05)。结论在常规治疗的基础上加用坎地沙坦可以更好地改善CHF患者的心功能,坎地沙坦能明显降低血浆ET和ANP的水平,这可能是ARB治疗CHF的机制之一。Objective To investigate the effect of candesartan in patients with congestive heart failure（CHF） and to observe the effect of candesartan on plasma endothelin（ET） and atrial natriuretic peptide（ANP） level among them. Methods Fifty patients with CHF were randomly allocated to a routine therapy group （control group, n = 25） and a routine therapy plus candesartan 4-8mg/d treatment group （n= 25）. Before and after 8 weeks of the two therapies, the changes of NYHA classification, plasma level of ET and ANP were assessed and evaluated. Results After 8 - week treatment, the NYHA classification and the plasma levels of ET and ANP decreased significantly in the candesartan group （P〈 0.01 ）, although the clinical efficacy in the candesartan group showed better improvement than the control group, but not reached statistical significance, however （P 〉 0.05）. Conclusion The efficacy of candesartan is effective and safe for patients with CHF, and significant reduction of the plasma ET and ANP levels may be one of its mecnanisms in treatment of OHF.

关 键 词：坎地沙坦 充血性心力衰竭 血浆内皮素 心钠素 

分 类 号：R541.61[医药卫生—心血管疾病]