慢性心衰患者外周血管功能改变及厄贝沙坦干预的影响  

The change of peripheral vascular function in patients with congestive heart failure and the effect of irbesartan intervention

作　　者：阮长武[1] 陈锐[1] 李志平[1] 沈艳[1] 李谨[1] 蒋云[1] 

机构地区：[1]上海市第八人民医院心内科,上海200335

出　　处：《中国民康医学》2009年第3期226-228,共3页Medical Journal of Chinese People’s Health

摘　　要：目的：旨在探讨血管病变检测系统在慢性心力衰竭（CHF）患者外周血管结构和功能评价中的价值,并了解厄贝沙坦干预的效果。方法：运用血管病变检测系统对35例正常人和47例CHF患者外周血管功能进行测定,并将47例CHF患者随机分为常规治疗组和厄贝沙坦组,观察治疗前后两组外周血管功能指标[四肢血压SBP、DBP、PP、MAP、肱踝脉搏波传导速度（BaPWV）及踝臂指数（ABI）]和心脏射血分数（EF）改变的情况。结果：常规治疗组和厄贝沙坦组四肢血压均明显高于正常对照组,治疗后两组血压均显著下降,厄贝沙坦组下降更为突出。两组BaPWV均高于正常对照组[分别为（1731.63±263.20）cm/s比（1426.35±312.47）cm/s,P〈0.05;（1716.50±320.40）cm/s比（1426.35±312.47）cm/s,P〈0.05];两组治疗后均较治疗前明显下降[治疗后分别为（1610.42±278.26）cm/s,（1482.70±306.21）cm/s,P均〈0.05]。两组ABI和EF均较正常对照组下降,治疗后均明显升高,厄贝沙坦升高更显著。结论：血管病变检测系统对于CHF患者外周血管结构和功能评价很有价值。CHF患者外周血管功能早期明显异常,常规抗心衰治疗和厄贝沙坦治疗均能明显改善CHF患者外周血管功能,厄贝沙坦治疗效果更优。Objective：To investigate the value of vascular disease detection system in evaluating congestive heart failure （CHF） patients＇peripheral vascular structure and function , and understand the effect of irbesartan intervention. Methods： To detect peripheral vascular function of 35 normal persons and 47 patients with CHF with vascular disease detection system. 47 patients with CHF were randomly divided into conventional treatment group and irbesartan group, observing of peripheral vascular function （ limbs blood pressure, SBP, DBP, PD, MAP） , cardiac ejection fraction（ EF）, brachial ankle pulse wave transmission velocity （BaPWV） and ankle - brachial index（ABI） before and after treatment. Results： The blood pressure of four limbs in conventional treatment group and ibesartan group were significantly higher than the normal control group. After treatment , blood pressure of the two groups were significantly decreased, irbesartan group decreased more obviously. The BaPWV of two treatment groups is faster than the normal control group [ （ 1731.63 ± 263.20） cm/s vs （ 1426.35 ± 312.47 ） era/s, P 〈 0.05 ; （ 1716.50 ± 320.40） cm/s vs （ 1426.35 ± 312.47） cm/s, P 〈 0.05 ], but they decreased significantly after treatment than before treatment [ after treatment （ 1610.42± 278.26 ） cm/s, （ 1482.70 ± 306.21 ）cm/s ,respectively; P 〈 0.05 ]. Both ABI and EF of the two groups were decreased as compared with the normal control groups. They were significantly increased after treatment , especially irbesartan increased more obviously. Conclusions： Vascular disease detection system is very valuable in evaluating the peripheral vascular structure and function of patients with CHF. The patients＂ peripheral vascular function is significant anomaly in early stage of CHF. Both conventional treatment and irbesartan can significantly improve the peripheral vascular function of patients with CHF , but irbesartan treatment is better.

关 键 词：慢性心力衰竭 血管病变检测系统 厄贝沙坦 

分 类 号：R541.6[医药卫生—心血管疾病]