血管紧张素Ⅱ受体拮抗剂治疗充血性心力衰竭中醛固酮的变化

The changes of aldosterone in the treatment of congestive heart failure by angiotensinⅡreceptor blockers

目的观察缬沙坦、苯那普利和2者合用对心力衰竭患者血浆醛固酮的影响及疗效。方法将60例心力衰竭患者分为3组,分别为口服缬沙坦组(valsartan,80mg/d)、苯那普利组(benazepril,10mg/d)和缬沙坦(80mg/d)与苯那普利(10mg/d)联合治疗组,均治疗4周。用放射免疫方法测定血浆醛固酮的变化。结果缬沙坦组醛固酮水平治疗后较治疗前显著下降(P<0.01),苯那普利组治疗前后无明显变化(P>0.05),联合治疗组治疗后较治疗前显著下降(P<0.01)。结论血管紧张素Ⅱ受体拮抗剂(ARB)或ARB与血管紧张素转换酶抑制剂(ACEI)合用对醛固酮的抑制作用强于ACEI。

Objective To investigate the changes of aldosterone in the treatment of congestive heart failure by only valsartan, only benazepril, and valsartan combined with benazepril. Methods Sixty patients were divided into three groups and were treated for 4 weeks： （1） Valsartan 80 mg/d; （2） Benazepril 10 mg/d; （3） Valsartan 80 mg/d and Benazepril 10 mg/d. The venous blood samples were obtained before and 4 weeks after the treatment. Aldosterone levels were measured by radioimmunity technique. Results The aldosterone levels in valsartan group decreased significantly after treatment （P 〈 0.01）. There was no significant difference in aldosterone levels in benazepril group before and after treatment （P 〉 0.05）. The aldosterone levels in combined treatment group decreased significantly after treatment （P 〈 0.01）. Conclusion The inhibitory effect of angiotensin Ⅱ receptor blockers （ARB） or combined application of ARB with angiotensin coverting enzemy inhibitor （ACEI） on the levels of aldosterone was greater than that of ACEI.