内科

目的探讨缬沙坦对严重心力衰竭患者血浆脑钠肽前体（NT-proBNP）水平及左室舒张功能的影响。方法心功能Ⅳ级的心力衰竭患者86 例，随机分为两组，常规治疗组（对照组）43例，缬沙坦组（观察组）43例，在常规抗心力衰竭治疗的基础上，给予缬沙坦治疗， 6个月后，观察血浆NT-proBNP水平变化及超声心动图各项指标，并进行比较。结果两组患者治疗6个月后血浆NT-proBNP水平均较治疗前显著降低（P＜0.05），但观察组降幅比对照组明显，差异有统计学意义（P＜0.05）。两组患者左心室质量指数（LVMI）、左室等容舒张时间（IVRT）均较治疗前降低、缩短（P＜0.05），舒张早期和晚期最大速度比值（E/A ）均较治疗前显著升高（P＜0.05），观察组治疗后LVMI，IVRT及E/A比值改善程度比对照组更显著，差异有统计学意义。结论缬沙坦能显著降低严重心力衰竭患者的血浆脑钠肽前体水平，能明显改善左室肥厚及舒张功能。

ObjectiveTo explore the effect of valsartan on N-terminal-pro-brain natriuretic peptide (NT-proBNP) and left ventricular diastolic function in severe heart failure patients.Methods86 patients with heart failure of grade IV were randomly divided into two groups,routine treatment group (control group,n=43) and valsartan group (experimental group,n=43) to receive treatment of valsartan on the basis of routine treatment. The changing of the levels of NT-proBNP and the indexes of echocardiogram were observed after six months treatment and made comparison.ResultsAfter six months of treatment,the levels of plasma NT-proBNP of both groups decreased obviously (P＜0.05).There were statistic differences between controlled group and experimental group in term of level of NT-proBNP (P＜0.05).The LMVI and the IVRT dropped obviously (P＜0.05).The ratio of E/A raised significantly (P＜0.05).The LMVI,the IVRT and the ratio of E/A of the experimental group improved significantly (P＜0.05).And there were statistic differences in comparison with those of the control group.ConclusionValsartan can significantly reduce the level of NT-proBNP of severe heart failure patients and improve the hypertrophy and diastolic functions of left ventricles.