卡维地洛治疗CHF的短期疗效及其对血浆脑钠素、N-端脑钠素前体的影响  

Short-term curative effect of carvedilol in the treatment of CHF and influence on plasma brain natriuretic peptide and N-terminal pro-brain natriuretic peptide

作　　者：赵士超[1] 曹林生[1] 

机构地区：[1]华中科技大学协和医院

出　　处：《山东医药》2007年第25期16-18,共3页Shandong Medical Journal

基　　金：河南省卫生厅科技创新项目(200312178)。

摘　　要：目的探讨卡维地洛治疗慢性心力衰竭(CHF)的短期疗效及其对血浆脑钠素(BNP)、N-端脑钠素前体(NT-proBNP)的影响。方法将92例CHF患者随机均分为两组,在抗心衰治疗基础上,治疗组加用卡维地洛,对照组加用比索洛尔,疗程均为8周。治疗前及治疗后8周观察临床疗效、左心室射血分数(LVEF)、心排血量(CO)及心排血指数(C I),以及血浆BNP和NT-proBNP。结果对照组LVEF、CO及C I治疗前后无显著变化,治疗组均显著提高(P<0.05);两组治疗后血浆BNP、NT-proBNP均显著降低,但以治疗组降低更明显(P<0.05)。结论卡维地洛能在短期改善CHF患者的心功能,且无其他β受体阻滞剂应用早期使心功能恶化的作用。血浆BNP、NT-proBNP是反映心衰严重程度、判断疗效的敏感指标。[ Objective ] To investigate short-term curative effect of carvedilol in treating chronic cardiac failure （CHF） and the influence on plasma brain natriuretic peptide and N-terminal pro-brain natriuretic peptide. [ Methods] 92 CHF patients were randomly divided into treatment group and control group. On the base of anti- CHF, carvedilol was used in treatment group , bisoprolol was used in control group. Course of treatment was 8 weeks. Before therapy and post-treatment 8 weeks,clinical curative effect , left ventricular ejection fraction （ LVEF）, cardiac output （ CO）, stroke work index （ CI）, plasma brain natriuretic peptide（BNP） and NT-proBNP were observed. [ Results] The LVEF, CO and CI were not improved in the control group, but they were significantly improved in treatment group（ P 〈 0.05）. The changes of heart rate, blood pressure and MPAP were not significant in both group. The plasma levels of NT-proBNP and BNP were significantly degraded after treatment in both groups, especially in the treatment group（ P 〈 0.05）. [ Conclusion ] Carvedilol can im- prove CHF heart function without heart function aggravation caused by early using of other β receptor blocker. The plasma levels of BNP and NT-proBNP are sensitive markers of severity of heart failure and judging curative effect.

关 键 词：卡维地洛 比索洛尔 心力衰竭 慢性 脑钠素 N-端脑钠素前体 

分 类 号：R541.6[医药卫生—心血管疾病]