福辛普利对心力衰竭患者血浆内皮素-1和降钙素基因相关肽的影响

The effect of fosinopril on plasma endothelin-1 and calcitonin gene-related peptide levels in patients with chronic heart failure

目的了解心力衰竭患者血浆内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)和降钙素基因相关肽(CGRP)的变化,并观察福辛普利对其的影响。方法测定40名健康者(正常对照组)和90例心力衰竭患者血浆ET-1、AngⅡ和CGRP浓度,随后90例心力衰竭患者被随机分成常规治疗组和福辛普利组(常规治疗+福辛普利10mg,1次/d),每组45例。治疗14d后复测血浆ET-1、AngⅡ和CGRP浓度,同时应用彩色多普勒超声显像仪测量正常对照组和心力衰竭患者治疗前后的左心室射血分数(LVEF)。结果与正常对照组相比较,心力衰竭患者血浆ET-1、AngⅡ明显升高(P<0.01),ET-1和AngⅡ与LVEF呈负相关(r=-0.71,r=-0.62,P<0.01),ET-1和AngⅡ呈正相关(r=0.69,P<0.01)。治疗14d后,福辛普利组血浆ET-1和AngⅡ明显下降(P<0.01),CGRP显著升高,(P<0.01),LVEF得到改善(P<0.05),而常规治疗组无明显变化(P>0.05)。结论心力衰竭患者血浆ET-1、AngⅡ浓度明显升高,且与LVEF呈负相关,血浆CGRP显著下降。福辛普利具有降低ET-1和AngⅡ、升高CGRP并改善LVEF的作用。

Objective To examine the levels of plasma endothelin-1 （ET-1）, angiotensinII （AngⅡ）and calcitonin gene-related peptide （CGRP） levels, and study the effect of Fosinopril on the above parameters in patients with chronic heart failure（CHF）. Methods Plasma levels of ET-1,AngⅡ and CGRP were detected in 40 normal controls and 90 patients with CHF.Ninity patients with CHF were randomized to receive Fosinopril 10 mg in addition to Conventional therapy,or only conventional therapy for 14 days. Plasma ET-1,AngⅡ and CGRP were detected at baseline and 14 days after treatment. Left ventricular ejection fractions（LVEF） were measured before and after 14 days of treatment. Results Compared with normal controls.CHF patients had increased in levels of plasma ET-1 and AngⅡ（P〈0.01）. Plasma CGRP had decreased（P〈0.01）. LVEF was significantly negatively correlated with the levels of ET-1（r=-0.71,P〈0.01）,and AngⅡ（r=-0.62,P〈0.01）,ET-1 positively correlated AngⅡ（r=0.69,P〈0.01）,administration of Fosinopril was associated with the decreasing of the levels of plasma ET-1 and increasing the levels of CGRP（P〈0.01）.LVEF increastd after 14 days of treatment by Fosinopril（P〈0.05）. No significant changes were found on conventional therapy（P〉0.05）. Conclusion The levels of plasma ET-1,AngⅡ and CGRP are abnormal in CHF patients. ET-1 and AngⅡ were negatively correlated with LVEF.Fosinopril can modulate the levels of ET-1,AngⅡ and CGRP, or improve LVEF in CHF patients.