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盐酸贝那普利对原发性高血压左室舒张功能及血清脑钠肽浓度的影响
作者:杨青茹 
单位:东南大学医学院附属徐州医院,老年病科,江苏,徐州,221009
关键词:盐酸贝那普利 高血压 脑钠肽 左室舒张功能 疗效评价 
分类号:R544.1
出版年·卷·期(页码):2007·26·第一期(52-54)
摘要:

目的:观察盐酸贝那普利(洛汀新)对原发性高血压左室舒张功能及血清脑钠肽(BNP)浓度的影响.方法:选择仅存在左室舒张功能障碍的原发性高血压病人52例,按有无左室肥厚(LVH)分为LVH组及非LVH组,均给予盐酸贝那普利口服20周,用药前后分别检测血清BNP浓度,并采用超声心动图及彩色多普勒技术测定心脏结构、左室舒张功能参数.结果:两组用药后左室舒张功能各参数较用药前均有显著改善,其中E峰减速时间(DT)显著降低(P<0.05),E/A值显著增高(P<0.05),E峰减速度(DC)显著增高(非LVH组P<0.01,LVH组P<0.05),血清BNP浓度显著降低(非LVH组P<0.05,LVH组P<0.01),左室质量指数(LVMI)无显著变化(P>0.05).两组患者治疗后其BNP降低与E/A增高具有负相关关系(非LVH组r=-0.409,P<0.05;LVH组r=-0.483,P<0.01).结论:盐酸贝那普利能明显改善高血压患者左室舒张功能障碍,降低血清BNP浓度,且左室舒张功能障碍越重,血清BNP浓度降低越明显;血清BNP浓度可作为评价盐酸贝那普利治疗高血压左室舒张功能障碍的疗效评价指标.

Objective To study the effects of benazepril HCl on left ventricular diastolic function and serum brain natriuretic peptide(BNP)level in patients with essential hypertension.Methods According to the result of echocardiography,52 hypertension patients were divided into left ventricular hypertrophy group and non-left ventricular hypertrophy group.All patients had been given benazapril HCl for 20 weeks.BNP and echocardiography were done before and after the treatment.Results The parameters of left ventricular diastolic function of two groups were improved after the treatment with benazepril.DT decreased significantly(P<0.05),E/A rate increased significantly(P<0.05),DC increased significantly(non-LVH group P<0.01,LVH group P<0.05),serum BNP level in two groups decreased significantly(non-LVH group P<0.05,LVH group P<0.01).LVMI had no significant change(P>0.05).After the management,the decrease of BNP was negatively related to the increase of E/A rate in both groups(no-LVH group r=-0.409,P<0.05,LVH group r=-0.483,P<0.01).Conclusions Not only can benazapril HCl improve left ventricular diastolic function but also lower BNP levels in patients with hypertension.The more serious the left ventricular diastolic dysfunction,the more the decrease of serum BNP level.Serum BNP level may serve as a therapeutic indicator for benazapril HCl treatment in hypertension patients with left ventricular diastolic disfuction.

参考文献:

[1] 张抒杨, 戴玉华. 全国高血压左室肥厚临床及基础研讨会纪要, 1994(3)
[2] SOBUE T, YOKOTA M, IVASE M. Influence of left ventricular hypertrophy on left ventricular function during dynamic exercise in the presence of coronary artery disease, 1995(1)
[3] 崔宏, 徐东, 袁其晓. 自发性高血压大鼠血浆与心房内脑钠尿肽水平的变化, 1989(3)
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