钟冬梅　胡英　王苓

[摘要] 目的 探讨贝那普利对慢性心力衰竭患者疗效及血浆脑钠素、高敏C反应蛋白的影响。 方法 选取本院2011年12月～2014年12月诊治的慢性心力衰竭患者189例，采用随机数字表法分为3组，63例患者实施常规治疗为对照组，63例患者加用贝那普利（2.5mg/次，2次/d）为A组，63例患者加用贝那普利（5mg/次，2次/d）为B组，比较3组患者心脏指标的改变情况、检测指标的改变情况、临床疗效、不良反应情况。 结果 治疗后，3组患者左室收缩末期内径、左室舒张末期内径、血浆脑钠素、高敏C反应蛋白均显著降低，左室射血分数、6min步行距离均显著增加。A组患者左室收缩末期内径、左室舒张末期内径、血浆脑钠素、高敏C反应蛋白均明显低于对照组，左室射血分数、6min步行距离、总有效率均明显高于对照组。B组患者左室收缩末期内径、左室舒张末期内径、血浆脑钠素、高敏C反应蛋白均明显低于对照组和A组，左室射血分数、6min步行距离、总有效率均明显高于对照组和A组。差异均有统计学意义（P<0.05）。 结论 贝那普利是治疗慢性心力衰竭的有效药物，可显著降低血浆脑钠素、高敏C反应蛋白水平，提高心功能，疗效显著，具有较高的安全性，值得临床推广使用。

[关键词] 贝那普利；慢性心力衰竭；疗效；脑钠素；高敏C反应蛋白；临床价值

[中图分类号] R541.4 [文献标识码] B [文章编号] 2095-0616（2015）18-125-04

[Abstract] Objective To investigate influence of plasma brain natriuretic peptide， high sensitive C reactive protein and clinical effect of Benner Pury in patients with chronic heart failure. Methods 189 patients with chronic heart failure were selected in hospital from December 2011 to December 2014， who were divided into three groups by random number table method. 63 patients received routine treatment as control group. 63 patients combined Benner Pury（2.5mg/time， 2 times/d） as group A. 63 patients combined Benner Pury（5mg/time， 2 times/d） as group B. Changes of cardiac indexes and detection indexes； clinical effect； adverse reactions were compared between three groups. Results After treatment， left ventricular end systolic diameter； left ventricular end diastolic diameter； plasma brain natriuretic peptide； high sensitive C reactive protein decreased significantly while left ventricular ejection fraction； 6 min walking distance increased significantly in three groups. Left ventricular end systolic diameter； left ventricular end diastolic diameter； plasma brain natriuretic peptide； high sensitive C reactive protein in group A were significantly lower than control group. Left ventricular ejection fraction； 6 min walking distance； total effective rate in group A were significantly higher than control group. Left ventricular end systolic diameter； left ventricular end diastolic diameter； plasma brain natriuretic peptide； high sensitive C reactive protein in group B were significantly lower than control group and group A. Left ventricular ejection fraction； 6 min walking distance； total effective rate in group B were significantly higher than control group and group A.Differences were statistically significant（P<0.05）. Conclusion Benner Pury is an effective drug in treatment of chronic heart failure， which can significantly reduce plasma brain natriuretic peptide and high sensitive C reactive protein level， which can significantly improve heart function， which has significant clinical effect and high security， which is worthy of clinical use.endprint

[Key words] Benner Pury； Chronic heart failure； Clinical effect； Brain natriuretic peptide； High sensitivity C reactive protein； Clinical value

慢性心力衰竭是临床常见病和多发病，是一种由于各种器质性心脏疾病引发的相对比较复杂的临床症候群，具有较高的致死率和致残率，高发于老年人[1]，且患者常伴有不同程度的血浆脑钠素升高[2]和高敏C反应蛋白升高[3]，这会恶化患者的病情，增加治疗的难度。贝那普利是新一代长效血管紧张素转换酶抑制剂，可用于慢性心力衰竭的治疗[4]。……