充血性心力衰竭患者血浆内皮素水平变化及药物干预的临床研究

Variations of plasma endothelin level in patients with congestive heart failure and drug intervention

目的 观察福辛普利对充血性心力衰竭 (Congestiveheartfailure ,CHF)患者血浆内皮素 (Endothelin ,ET)水平及心功能变化的影响 ,并探讨其相关机制。方法 采用放射免疫法检测福辛普利组及常规治疗对照组患者治疗前和治疗 12周后血浆ET水平 ,同时间点采用超声心动图检测左室射血分数 (Leftventricularejectionfraction ,LVEF)和二尖瓣血流最大流速E峰和A峰比值 (E/A) ,并以 38例健康体检者作为正常对照组。结果 CHF患者ET水平显著高于对照组 ,福辛普利治疗 12周后 ,CHF患者的ET水平显著降低 ,LVEF、E/A值显著提高。结论 CHF患者ET水平增高可作为判断CHF病情的指标之一 ;福辛普利可降低CHF患者的ET水平 ,改善CHF患者的心脏功能。

Objective To investigate the effects of fosinopril on plasma endothelin(ET) level and cardiac function in patients with congestive heart failure(CHF) and to explore the related mechanism.Methods Eighty-six patients with CHF were randomly divided into fosinopril group and conventional treatment group, and 38 healthy subjects were recruited as normal control group. The plasma levels of ET, left ventricular ejection fraction (LVEF)and E/A were measured pre-treament and 12 weeks post-treatment by using radioimmunoassay and echocardiography.Results (1)The plasma levels of ET in patients with CHF were significantly higher than those in healthy controls.(2)Compared with conventional treatment group, the plasma ET level in fosinopril group was significantly lower,and the LVEF and E/A were significantly higher on 12 weeks post-treatment.Conclusion The plasma level of ET is an important index for assessing the severity of cardiac dysfunction in patients with CHF, and fosinopril improves the cardiac function by decreasing the plasma level of ET.