马来酸依那普利叶酸片对老年慢性心力衰竭患者血清和肽素、N-末端 B 型利钠肽前体及同型半胱氨酸水平的影响研究

摘要

Objective To investigate the impact of enalapril maleate - folate tablets on serum levels of Copeptin, NT-proBNP and Hcy in aged patients with chronic heart failure. Methods A total of 90 aged patients with chronic heart failure were selected in the Third Hospital of Changsha from January 2014 to January 2015,and they were divided into control group and observation group according to double - blind,controlled and random principles,each of 45 cases;and a total of 45 healthy cases for physical examination were selected as blank group at the same time. Based on conventional medical treatment,patients of observation group were given enalapril maleate - folate tablets,patients of control group were given enalapril tablets,while cases of blank group were given placebo. Serum levels of Copeptin,NT-proBNP and Hcy before treatment were compared in CHF patients with different NYHA cardiac functional grades and healthy cases,serum levels of Copeptin,NT-proBNP and Hcy before treatment,at the forth week of treatment,at the eighth week of treatment were compared between observation group and control group. Results Serum levels of Copeptin,NT-proBNP and Hcy of patients with Ⅱ to Ⅳ NYHA cardiac functional grades were statistically significantly higher than those of healthy cases( P ﹤ 0. 05);above index of patients with Ⅲ to Ⅳ NYHA cardiac functional grades were statistically significantly higher than those of patients with Ⅱ NYHA cardiac functional grades( P ﹤0. 05);and above index of patients with Ⅳ NYHA cardiac functional grades were statistically significantly higher than those of patients with Ⅲ NYHA cardiac functional grades(P ﹤ 0. 05). No statistically significant differences of serum level of Copeptin, NT-proBNP or Hcy was found between observation group and control group before treatment(P ﹥ 0. 05);at the forth week of treatment and at the eighth week of treatment,serum levels of Copeptin,NT-proBNP and Hcy of observation group were statistically significantly lower than those of control group( P ﹤ 0. 05). Conclusion Enalapril maleate - folate tablets can effectively reduce the serum levels of Copeptin,NT-proBNP and Hcy of aged patients with chronic heart failure,is helpful to improve the patients' prognosis.%目的：探讨马来酸依那普利叶酸片对老年慢性心力衰竭患者血清和肽素、N-末端 B 型利钠肽前体（NT-proBNP）及同型半胱氨酸（Hcy）水平的影响。方法选取长沙市第三医院2014年1月—2015年1月收治的老年慢性心力衰竭患者90例，根据双盲、对照及随机原则分为观察组和对照组，每组45例；选取同期在长沙市第三医院体检中心体检健康者45例作为空白组。在常规药物治疗基础上，观察组患者给予马来酸依那普利叶酸片治疗，对照组患者给予依那普利片治疗，空白组受试者给予安慰剂。比较不同心功能分级患者与空白组受试者血清和肽素、NT-proBNP、Hcy 水平及观察组与对照组患者治疗前、治疗第4周、治疗第8周血清和肽素、NT-proBNP、Hcy 水平。结果心功能分级为Ⅱ~Ⅳ级者血清和肽素、NT-proBNP、Hcy 水平高于空白组，心功能分级为Ⅲ~Ⅳ级者血清和肽素、NT-proBNP、Hcy 水平高于心功能分级为Ⅱ级者，心功能分级为Ⅳ级者血清和肽素、NT-proBNP、Hcy 水平高于心功能分级为Ⅲ级者（P ﹤0.05）。治疗前观察组与对照组患者血清和肽素、NT-proBNP、Hcy 水平比较，差异均无统计学意义（P ﹥0.05）；治疗第4、8周，观察组和对照组患者血清和肽素、NT-proBNP、Hcy 水平低于治疗前，且观察组患者血清和肽素、NT-proBNP、Hcy 水平低于对照组（P ﹤0.05）。结论马来酸依那普利叶酸片可有效降低老年慢性心力衰竭患者血清和肽素、NT-proBNP及 Hcy 水平，有助于改善患者预后。