老年心力衰竭患者肾素-血管紧张素系统与纤溶活性变化的意义

Effect of Renin Angiotensin System on Fibrinolytic Function in Elderly Patients with Chronic Heart Failure

目的探讨老年心力衰竭(HF)患者血浆肾素-血管紧张素系统(RAS)与纤溶活性的变化。方法老年HF患者46例(HF组),非器质性心脏病住院患者18例(对照组),取静脉血分别检测血浆纤溶酶原激活剂抑制物1(PAI-1)、组织纤溶酶原激活剂(t-PA)活性、血浆肾素活性(RA)及血管紧张素Ⅱ(AngⅡ)含量。结果老年HF患者血浆RA、PAI-1活性、AngⅡ含量明显高于对照组(P<0.05),t-PA活性则降低(P<0.05);血浆PAI-1活性与AngⅡ含量水平呈显著正相关(r=0.396,P<0.01)。结论老年HF过程中血浆RAS激活对纤溶活性改变有重要影响。

Objective To investigate the changes of renin angiotensin system （RAS） and fibrinolytic function in elderly patients with chronic heart failure （CHF）.Methods The levels of Plasma plasminogen activator inhibitor type-1（PAI-1）, tissue plasminogen activator（t-PA）, plasma renin activity （PRA） and angiotensinⅡ（AngⅡ） were measured in 46 elderly patients with CHF and 18 normal subjects. Results The mean levels of PRA, AngⅡand PAI-1 in the CHF group were significantly higher than those in control （P〈0.05）, while the activity of tPA in the CHF was lower（P〈0.05） Compared with that in control. There was a positive correlation between activity of plasma PAI-1 and AngⅡlevel in elderly patients with CHF （r=0.976,P〈0.01）.Conclusion RAS might contribute to regulate the endogenous fibrinolytic function in elderly patients with CHF.