替米沙坦对高血压患者左心室重构及血浆b型钠尿肽的影响

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1、【摘要】　　目的探讨替米沙坦对左心室重构和血浆BNP浓度的影响。方法选取高血压患者94例，其中不伴左室肥厚（LVH）患者44例，伴LVH患者50例，健康对照组46例。高血压患者给予替米沙坦80mgqd治疗32周。所有对象治疗前后均测左心室重量指数(LVMI)，BNP，射血分数（EF），用SPSS13.0进行统计分析。结果高血压无LVH组及有LVH组治疗前后各指标有明显差异（P＜0.05),对照组无明显差异（P＞0.05)；BNP的变化值与LVMI和EF的变化值正相关。结论无高血压者、高血压不伴和伴左室重构者BNP，EF具有明显差异，血浆BNP水平可反映左室重构和左心功

2、能。替米沙坦对抑制和逆转左室重构，改善心功具有显著作用。【关键词】替米沙坦；高血压；心室重构；心力衰竭　　EffectofTelmisartenonLeftVentricularRemodelingandB-typeNatriureticPeptideofthePatientswithHypertension　　GongWutian,LiJiafu　　DepartmentofCardiology,the1stPeople’sHospitalofGuangyuanCitySichuanProvince628017,P.R.China　　AbstractObjective

3、Tostudytheeffectoftelmisartenonleftventricularremodelingandplasmab-typenatriureticpeptide(BNP).Methods94caseswithhypertensionformedtheexperimentgroup,including44caseswithoutleftventricularhypertrophy(LVH)and50caseswithLVH;46normalformedthecontrolgroup;telmisarten,80mg,onceaday,wasadmini

4、stratedtocasesintheexperimentgroupandthecourselastedfor32weeks.;LVMI,BNPandejectionfracture(EF)ofallthecasesinbothgroupsweredetectedbeforeandaftertreatmentandtheresultswerestatisticallyanalyzedbythesoftwareSPSS13.0.ResultsThereexistedobviousdifferencesineachindexbeforeandaftertreatmentb

5、etweenthepatientswithhypertensionwithoutLVHandthosewithhypertensionandLVH(P＜0.05),andnoobviousdifferencewasfoundincontrolgroup(P＞0.05);thechangevalueofBNPwaspositivelycorrelatedwiththatofEF.ConclusionsTheBNPandEFofpatientswithnohypertensionandpatientswithhypertensionandleftventricularre

6、modelingorwithhypertensionbutwithoutleftventricularremodelingareofsignificantdifference,theplasmaBNPlevelcanreflectleftventricularremodelingandleftventricularfunction;telmisarteniseffectiveininhibitingandreversingleftventricularremodelingandinimprovingcardiacfunction.　　KEYWORDStelmisart

7、enhypertensionventricularremodelingheartfailure高血压病系进展缓慢的疾病，在其进程中，左心室发生重构越来越重，进而加重心衰。探讨重构和心衰的关系，并进一步明确反映重构和心衰的指标，才能采取有效措施，延缓其发展进程。近年来研究已明确，重构与心衰有密切关系，BNP可反映心衰，但明确其到底能否反映心衰，与收缩性心衰的指标EF及重构有无相关性，能否找到逆转重构和减轻心衰的长期切实有效的措施或药物对提高病员生存率，降低死亡率具有重要意义。本研究用超声多普勒仪检测心室肥厚和心衰的相关指标，并用放免γ测量仪检测BNP，