充血性心力衰竭患者血浆一氧化氮和内皮素含量及其临床意义

Plasma nitric oxide and endothelin levels in patients with chronic heart failure

目的：探讨血浆一氧化氮（ＮＯ）和内皮素（ＥＴ）的改变在充血性心力衰竭（ＣＨＦ）病程中的临床意义。方法：检测３５例ＣＨＦ患者外周静脉血和肺动脉血中ＮＯ、ＥＴ、血管紧张素转换酶（ＡＣＥ）的含量。以２０例健康体检者作为对照组。结果：ＣＨＦ患者外周静脉和肺动脉血浆中ＮＯ、ＥＴ含量显著高于健康对照组（Ｐ均＜０．０５）；血浆ＡＣＥ水平呈现相同的变化；血浆ＥＴ增加的幅度大于ＮＯ，因此，ＣＨＦ患者ＮＯ／ＥＴ比值降低（Ｐ＜０．０５）。这些变化在患者的肺动脉中比外周静脉中更明显（Ｐ均＜０．０５），与心力衰竭的严重程度有关。结论：血浆ＮＯ水平增高，ＮＯ／ＥＴ比值降低是ＣＨＦ的病理生理特征之一。

Objective:To investigate the clinical significance of changes in plasma nitric oxide (NO) and endothelin (ET) levels in patients with chronic heart failure (CHF).Methods:Using blood samples obtained from vein (V) and pulmonary artery (PA),NO,ET and angiotensinconverting enzyme (ACE) levels were determined in 35 patients with CHF.20 healthy subjects served as normal controls.Results:Plasma NO and ET levels in patients were much higher than those in normal subjects both in V and PA (all P <0 05).Also,plasma ACE levels showed a similar pattern.However,the increase in plasma ET was more obvious thalated to severity of heart failure according to New York Heart Association (NYHA) classification.Conclusions:The increase in plasma NO and decrease in NO/ET ratio might be a pathophysiological characteristic in CHF,which would reflect endothelial dysfunction in CHF.