氯沙坦对老年慢性心力衰竭患者心型脂肪酸结合蛋白的影响  

Effect of losartan on plasma heart-type fatty acid binding protein in elderly patients with chronic heart failure

作　　者：陈福生 谢启应[2] 

机构地区：[1]株洲恺德心血管病医院心内科,株洲412007 [2]中南大学湘雅医院心内科,长沙410008

出　　处：《中华老年多器官疾病杂志》2017年第8期599-603,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的观察老年慢性心力衰竭(CHF)患者氯沙坦治疗前后心型脂肪酸结合蛋白(H-FABP)和脑钠肽(BNP)水平的变化,探讨氯沙坦抑制心室重构的作用机制。方法入选2016年1月至2016年10月株洲恺德心血管病医院心内科左室射血分数降低的心力衰竭(HFrEF)患者129例,其中男性66例,女性63例,年龄(71.69±8.62)岁。根据服用氯沙坦剂量的不同分为高剂量组(n=65)和低剂量组(n=64),分别给予氯沙坦100 mg和氯沙坦25 mg每日口服,分别检测两组治疗前、治疗3个月及6个月后血浆H-FABP、BNP水平及左心室结构和功能的变化。采用SPSS 17.0统计软件进行数据分析。计量资料用均数±标准差(±s)表示,两组比较采用t检验,多组比较采用单因素方差分析。计数资料用百分率表示,组间比较用χ~2检验。结果相比治疗前,两组患者治疗后3个月与6个月H-FABP和BNP水平均下降,左室舒张末期容积(LVEDV)和左室收缩末期容积(LESV)减少,LVEF升高,差异具有统计学意义(P<0.05)。相比低剂量组,高剂量组患者治疗3个月与6个月的H-FABP、BNP、LVEDV和LVESV减少明显,LVEF升高也明显,差异具有统计学意义(P<0.05)。结论血管紧张素Ⅱ受体拮抗剂氯沙坦能抑制老年CHF患者H-FABP和BNP的分泌,延缓心室重构,改善心功能。Objective To determine the effects of losartan on the plasma levels of heart-type fatty acid binding protein （H-FABP） and brain natriuretic peptide （BNP） in the elderly patients with chronic heart failure （CHF）,and to investigate the possible mechanism of losartan in preventing ventricular remodeling.Methods A total of 129 CHF elderly patients （aged 71.69±8.62 years,66 males and 63 females） suffering from heart failure with left ventricular reduced ejection fraction （HFrEF） who were hospitalized in our department from January to October 2016 were recruited in this study.They were divided into high-dose group （n=65） and low-dose group （n=64） according to the dose of losartan,and were given 100 mg or 25 mg,respectively.The plasma levels of H-FABP and BNP were measured,and the structure and functions of left ventricle were evaluated at the baseline,3 and 6 months after losartan treatment.SPSS statistics 17.0 was used to analyze the data.The measurement data were expressed as mean±standard deviation （x^-±s）,and Student＇s t test was employed for the comparison between groups.Enumeration data were expressed as percentage,and inter-group comparison was carried out with Chi-square test.Results Compared with the baseline levels,the H-FABP and BNP levels were decreased,left ventricular end-diastolic volume （LVEDV） and left ventricular end-systolic volume （LVESV） were reduced,but left ventricular ejection fraction （LVEF） was increased in both groups at 3 and 6 months after treatment （P〈0.05）.Compared with low-dose group,the changes in the above indices were more significant in high-dose group at 3 and 6 months after treatment （P〈0.05）.Conclusion Angiotensin Ⅱ receptor antagonist losartan inhibits the secretions of H-FABP and BNP in the elderly patients with CHF,and then prevents ventricular remodeling and improves the heart function.

关 键 词：老年人 心力衰竭 氯沙坦 心型脂肪酸结合蛋白 脑钠肽 

分 类 号：R542.2[医药卫生—心血管疾病]