充血性心力衰竭患者口服ACEIs后血浆ox-LDL、vWF及TAC改变的临床意义

Effect of angiotensin converting enzyme inhibitors on plasma ox-LDL,vWF and TAC levels in patients with congestive heart failure

目的本研究观察了67例充血性心力衰竭(CHF)患者口服培哚普利和依那普利后血浆氧化型低密度脂蛋白(ox-LDL)、血管性假血友病因子(vWF)及总抗氧化能力(TAC)的改变,探讨血管紧张素转换酶抑制剂(ACEIs)对体内氧化状态和血管内皮功能的影响。方法67例CHF患者随机给予依那普利或培哚普利治疗8周后,观察血浆ox-LDL、vWF及TAC水平的改变。35例健康志愿者作为正常对照组。血浆vWF和ox-LDL采用酶标法测定,血浆TAC水平采用分光光度计测定。结果两组CHF患者基础血浆ox-LDL、vWF水平高于健康对照组(P<0.01),血浆TAC水平低于正常对照组(P<0.01);服药4周后,依那普利组和培哚普利组血浆ox-LDL、vWF水平下降(P<0.05),8周后进一步下降(P<0.01);而血浆TAC水平在4周时升高(P<0.05),8周时进一步升高(P<0.01)。结论ACEIs如依那普利和培哚普利能提高CHF患者的抗氧化能力,改善血管内皮功能以及降低血栓形成倾向,从而对阻断CHF的恶性循环起到有益作用。

AIM To investigate the changes of plasma von Willebrand factor （vWF）, oxidized low density lipoprotein （ox-LDL） and total antioxidant capacity （TAC） levels in 67 patients with congestive heart failure after administration of Perindopril or Enalaprol and to discuss the effect of angiotensin converting-enzyme inhibitor （ACEI） on oxidative stress and vascular endothelial function in patients with congestive heart failure. METHODS Plasma TAC level was measured by spectrophotometer and plasma ox-LDL and vWF were measured with enzyme linked immunosorbant assay （ELISA）. RESULTS The baseline value of plasma TAC in patients with congestive heart failure was lower than that in healthy control subjects and the baseline values of plasma oxLDL and vWF were higher than that in control （P 〈 0.01 ）. The plasma TAC level in Perindopril group and Enalaprol group increased significantly 4 week after the administration （ P 〈 0.05 ） and rose more remarkably 8 week after the administration （ P 〈 0.01 ）. The plasma ox-LDL and vWF levels decreased 4 week after the administration （ P 〈 0.05 ） and reduced more remarkably 8 week after administration （P 〈0.01 ）. CONCLUSION ACEIs such as Perindopril and Enalaprol promotes the antioxidative ability and improves the poor vascular endothelial function in these patients, which may play a beneficial role in preventing the deterioration of congestive heart failure.