β-阻滞剂治疗心衰中血浆ET,NE,ANP的变化

Significance of the changes of plasma endothelin, norepinephrine and atrial natriuretic peptide in treatment of heart failure with β blocker

３０ 例心衰患者用强心利尿扩血管药物治疗２ 周，病情稳定后随机平分为Ａ，Ｂ 两组。Ａ 组加用倍他乐克治疗，Ｂ 组维持原方案治疗８ 周；Ｃ 组为正常对照组１６ 例。发现：①Ａ，Ｂ 两组血浆ＥＴ，ＮＥ 及ＡＮＰ 水平高于Ｃ 组；②治疗后Ａ 组血浆ＥＴ，ＮＥ，ＡＮＰ 水平下降程度，心机能分级，ＣＩ及ＬＶＥＦ 改善程度明显高于Ｂ 组；③血浆ＥＴ 下降值与各项指标的变化密切相关。提示：β受体阻滞剂能降低血浆ＥＴ，ＮＥ 及ＡＮＰ 水平，改善心机能；血浆ＥＴ 变化程度可作为评价心机能改善的可靠指标。

Thirty patients with chronic heart failure after conventional treatment for two weeks with cardiac diuretic and vasodilator were divided into two groups. There was addition of betaloc into Group A, but Group B kept the original treatment plan for 8 weeks. Group C consisted of 16 normal controls. The results showed that: ① The level of plasma endothelin(ET), norepinephrine(NE), atrial natriuretic peptide(ANP) in Group A and B were higher than those in Group C. ② The decreasing degrees of ET, NE, ANP, heart function score and the increasing degrees of CI and LVEF in Group A were more than those in Group B. ③ The change of ET was related to the changes of the others. Therefore, the β blocker may be associated with the decrease of the plasma concentration of ET, NE and ANP and improve heart function. It is considered that the degree of change of plasma ET may be the simple and reliable index which evaluate the degree of improving heart function.