奈西立肽对老年慢性心力衰竭患者心室重构和相关神经激素的影响  

Effect of nesiritide on cardiac remodeling and plasma neurohormone level in elderly chronic heart failure patients

作　　者：王丽霞[1] 罗萍[1] 黄彦生[2] 王光公[1] 赵士超[1] 段红艳[1] 

机构地区：[1]河南省人民医院心内科,郑州450003 [2]河南省人民医院康馨心血管内科,郑州450003

出　　处：《中华老年心脑血管病杂志》2014年第1期4-7,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省医学科技攻关计划项目(200903131)

摘　　要：目的探讨奈西立肽对老年慢性心力衰竭患者心室重构和血浆相关神经激素的影响。方法将96例慢性心力衰竭患者随机分为常规组32例、联合治疗组32例和奈西立肽组32例。分别在入院时和治疗后6个月进行心脏超声并检测血管紧张素Ⅱ(AngⅡ)、内皮素1及NO水平变化。结果与治疗前比较,常规组各项指标均有改善的趋势,但差异无统计学意义(P>0.05),联合治疗组和奈西立肽组LVEF和NO明显升高,左心室舒张末内径(LVEDD)明显缩小、AngⅡ和内皮素1明显降低(P<0.05,P<0.01);与常规组比较,联合治疗组和奈西立肽组LVEF和NO明显升高,LVEDD明显缩小、AngⅡ和内皮素1明显降低(P<0.05,P<0.01);与联合治疗组比较,奈西立肽组LVEF和NO明显升高,LVEDD、AngⅡ和内皮素1明显降低(P<0.05)。结论奈西立肽能改善老年慢性心力衰竭患者心脏功能,逆转心室重构,降低血浆AngⅡ及内皮素1,增加NO水平。Objective To study the effect of nesiritide on cardiac remodeiling and plasma neurohor- mone level in elderly chronic heart failure （CHF） patients. Methods Ninety-six elderly CHF pa- tients were divided into routine treatment group, combined treatment group and nesiritide treat- ment group （32 in each group）. The patients were treated for 6 months. The patients underwent electrocardiography at admission and 6 months after treatment. Their plasma angiotensin Ⅱ （Ang Ⅱ ）,endothelin 1 （ET-1） and nitric oxide （NO） levels were measured. Results No signifi- cant difference was found in plasma LVEF,NO,Ang Ⅱ and ET-1 levels and left ventricular end di- astolic dimension （LVEDD） in routine treatment group before and after treatment although they tended to improve （P〉0.05）. The plasma LVEF and NO levels were significantly higher whereas the LVEDD was significantly shorter and the plasma Ang Ⅱ and ET-1 levels were significantly lower in combined treatment group and nesiritide treatment group than in routine treatment group （P〈0.05, P〈0. 01）. The plasma LVEF and NO levels were significantly higher whereas the LVEDD was significantly shorter and the plasma Ang 1I and ET-1 levels were significantly lower in nesiritide treatment group than in combined treatment group （P〈0.05）. Conclusion Nesirit- ide can improve the cardiac function,reverse the cardiac remodeling, decrease the plasma Ang Ⅱ , ET-1 levels,and increase the plasma NO level in elderly CHF patients.

关 键 词：利钠肽 脑 心力衰竭 心室重构 神经递质药 血管紧张素Ⅱ 内皮缩血管肽1 一氧化氮 

分 类 号：R541.6[医药卫生—心血管疾病]