【摘要】 目的:观察缬沙坦对心力衰竭患者心室重构的影响。方法:选择充血性心力衰竭患者99例,心功能NYHAⅡ~Ⅳ级,左室射血分数(LVEF)<0.45。随机分成A、B、C 3组。A组:为对照组,予硝酸酯制剂、利尿剂、地高辛、β受体阻滞剂等常规治疗。B组:开搏通组,A组治疗+开搏通,目标剂量50 mg,3次/d。C组:缬沙坦组,A组治疗+缬沙坦,目标剂量80 mg,2次/d。疗程均3个月。用药前后测定心脏左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、相对室壁厚度(RWT)、短轴缩短率(FS)、心搏出量(SV)、LVEF;血清醛固酮(ALD)、内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)。结果:①C组治疗前后比较,ALD、ET-1、AngⅡ、LVEDD、LVESD显著降低和缩小(均P<0.05),RWT、LVEF、FS、SV显著增加(P<0.05)。②C组治疗后与A组治疗后比较,ALD、ET-1、AngⅡ、LVEDD、LVESD显著下降(均P<0.05),RWT、EF、FS、SV显著增加(均P<0.05);③C组治疗后与B组治疗后比较,ALD显著性降低(P<0.05),其它指标差异无显著性(均P>0.05)。结论:①缬沙坦能降低促使心室重构的ALD、ET-1、AngⅡ;②缬沙坦能明显逆转心室重构,改善心功能,效果与开搏通相似。更多还原

【Abstract】 AIM: To investigate the effect of valsartan on ventricular remodeling of heart failure patients.METHODS: Ninety nine congestive heart failure(CHF) patients(NYHA Ⅱ-Ⅳ,LVEF<0.45) were randomly divided into three groups: A.control group(routine treatment of nitrate,diuretic,digoxin, β-receptor blocker);B.captopril group(routine treatment plus captopril,target dosage 50 mg,three times per day);C.valsartan group(routine treatment plus valsartan,target dosage 80 mg,two times per day).Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),relative wall thickness(RWT),fraction shortening(FS),sendout volume(SV),eject fraction(EF),aldosterone(ALD),endothelin-1(ET-1) and angiontensinⅡ(AngⅡ) were measured.RESULTS: In group C,ALD,ET-1,AngⅡ,LVEDD,LVESD decreased significantly(P<0.05),while RWT,EF,FS,SV increased significantly(P<0.05) after the treatment.② Compared with group A,ALD,ET-1,AngⅡ,LVEDD and LVESD were significantly reduced(P<0.05),while RWT,ET,FS and SV significantly increased(P<0.05) in group C.③ Compared with group B,ALD of group C decreased significantly(P<0.05),while other indexes were not significantly changed.CONCLUSION: Valsartan,similar to Captopril,reverses ventricular remodelling by decreasing ALD,ET-1and AngⅡ and therefore improves cardiac function.更多还原