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目的观察血管紧张素受体拮抗剂厄贝沙坦对慢性充血性心力衰竭(CHF)病人血清脂联素浓度的影响。方法临床选择CHF病人69例,随机分为CHF对照组(38例)和CHF治疗组(31例)。CHF对照组和CHF治疗组均给予地高辛、利尿剂、硝酸甘油等常规治疗6个月,CHF治疗组除常规治疗外还加服厄贝沙坦片(150mg/日)连续6个月。所有研究对象均在治疗前后测定心脏左室舒张末内径(LVEDD)、左室射血分数(LVEF)、血清脑钠素(BNP)和脂联素水平。结果 (1)CHF对照组和CHF治疗组病人治疗前的BNP与脂联素水平成正相关(R=0.36,P<0.05)。(2)与治疗前对比,CHF对照组和CHF治疗组病人经过6个月的治疗后,LVEDD均无明显改变(P>0.05),但是两组LVEF有显著改善(P<0.05),血清BNP和脂联素水平均降低(P<0.05)。(3)治疗6个月后,CHF治疗组LVEF、血清BNP和脂联素水平与CHF对照组对比有明显差异(P<0.05)。结论厄贝沙坦可以升高CHF患者血清脂联素水平,从而进一步改善CHF病人的心功能。
Objective To observe the effect of irbesartan, an angiotensin receptor blocker, on serum adiponectin in patients with chronic congestive heart failure (CHF). Methods Sixty-nine patients with CHF were randomly divided into CHF control group (38 cases) and CHF treatment group (31 cases). CHF control group and CHF treatment group were given digoxin, diuretics, nitroglycerin and other conventional treatment for 6 months, CHF treatment group plus conventional Irbesartan tablets (150mg / day) for 6 consecutive months. All subjects were measured LVEDD, LVEF, BNP and adiponectin before and after treatment. Results (1) BNP level before treatment in CHF control group and CHF group was positively correlated with adiponectin level (R = 0.36, P <0.05). (2) LVEDD had no significant change (P> 0.05) after 6 months of treatment in CHF control group and CHF treatment group, but LVEF in both groups was significantly improved (P <0.05), serum BNP And adiponectin levels were lower (P <0.05). (3) After 6 months of treatment, the levels of LVEF, serum BNP and adiponectin in CHF group were significantly different from those in CHF group (P <0.05). Conclusion Irbesartan can increase the level of serum adiponectin in CHF patients and further improve the cardiac function in CHF patients.