卡托普利和硝苯地平对充血性心力衰竭患者肾素-血管紧张素系统的影响

Effects of captopril and nifedipine on pla'sma renin-angiotensin system in patients with congestive heart failure

充血性心力衰竭140例,随机分为卡托普利组70例(男性47例,女性23例,年龄62±13a),剂量12.5-25mg, tid,进行0.5-3mo治疗;硝苯地平组70例(男、女性各35例,年龄58±12a),剂量10mg,tid,疗程相仿。结果:血浆肾素活性增高以硝苯地平组更明显;血管紧张素Ⅱ与醛固酮的降低、心功能改善、射血分数增加以卡托普利组显著。

The 140 patients with congestive heart failure (CHF) were equally divided into 2 groups at random. Group A received captopril 12.5 mg tid for 2 wk-3 mo; group B received nifedipine 10 mg tid for 2 wk-3 mo. After treatment the plasma renin activity (PRA) increased more in group B as compared with group A (P< 0. 01). Angiotensin II (ACT H ), aldosterone and product of mean arterial pressure and heart rate (BP X HR) decreased and ejection fraction (EF) increased in group A as compared with group B (P< 0. 05, 0. 01). The percentage of improved cardiac function of group A (90%) was higher than that of group B (71%) (P<0. 05); there was a negative correlation between ACT II and EF% in group A (r = -0.33, P<0.01). It is suggested that captopril can decrease mortality and improve prognosis of patients with severe CHF.