【摘要】 目的:探讨血管紧张素II受体拮抗剂(ARB)药物缬沙坦胶囊对慢性心力衰竭(心衰)患者神经内分泌因子的影响。方法:将住院的慢性心衰患者,随机分为2组:对照组(43例)及缬沙坦治疗组(44例)。患者于治疗前及治疗后2个月后,检测血浆肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、β-内啡肽、脑钠肽(BNP)水平。结果:β-内啡肽、BNP、IL-10随着纽约心脏病协会心功能分级(NYHA分级)的升高而升高;NYHA分级2级组与NYHA分级3级组TNF-α水平均低于NYHA分级4级组。TNF-α、IL-10、β-内啡肽、BNP水平均与左室射血分数(LVEF)相关,相关系数分别为-0.35、-0.32、-0.47及-0.50(P<0.01)。缬沙坦组治疗后,LVEF明显提高、左室舒张末内经(LVDD)缩小,TNF-α、IL-10、β-内啡肽、BNP水平均降低(P<0.05);对照组LVDD变小,β-内啡肽、BNP水平也降低,而LVEF及TNF-α、IL-10无变化。缬沙坦组LVEF改善程度及LVDD缩小程度均优于对照组,各内因子水平降低程度均比对照组明显(P<0.05)。结论:缬沙坦可以改善慢性心衰患者心功能,逆转心室重构,抑制其神经内分泌及炎症因子激活。更多还原

【Abstract】 Objective:To observe the effects of valsartan(Diovan) on neuroendocrine factors in patients with chronic heart failure. Methods:Eighty-seven patients with chronic heart failure were enrolled in the study.The patients were randomly divided into conventional treatment group(43 cases) and valsartan group(44 cases).The serum levels of tumor necrosis factor-alpha (TNF-α),interleukin-10(IL-10),β-endorphin(β-EP) and brain natriuretic peptides(BNP) were measured before and after treatment in 8 weeks.Results:The serum levels ofβ-EP,BNP and IL-10 were significantly higher with the senior grades of New York Heart Association(NYHA),while the level of TNF-αwith NYHA functional classⅣwas higher than those with classⅡ-Ⅲ.The expressions of the four neuroendocrine factors were inversely correlated to the left ventricular ejection fraction(LVEF),with correlation coefficients of -0.35,-0.32,-0.47 and -0.50(P<0.01),respectively.The left ventricle end-diastole diameter were significantly decreased and LVEF were increased in the valsartan group than before treatment and the control group(P<0.05).The serum levels of TNF-α,IL-10,β-EP and BNP were significantly declined in the valsartan group,but in the control group,only the levels of BNP andβ-EP were decreased,while the levels of TNF-αand IL-10 showed no change.Conclusions:Valsartan could improve cardiac function and reverse myocardial remodeling,with inhibition of neuroendocrine factor and inflammatory cytokines.更多还原