慢性充血性心力衰竭患者血管紧张素Ⅱ和内皮素-1水平的变化及临床意义

Change and clinical significance of angiotensin Ⅱ and endothelin-1 in patients with congestive heart failure

目的探讨慢性充血性心力衰竭(CHF)患者血管紧张素Ⅱ(AngⅡ)和内皮素-1(ET-1)水平的变化及临床意义。方法选择50例CHF患者(治疗组)及40例年龄、性别、体重指数相匹配的健康患者(对照组),检测并比较两组的血浆AngⅡ和ET-1变化。结果治疗组治疗前的血浆AngⅡ和ET-1水平明显高于对照组,差异均有统计学意义(t分别=37.59、21.83,P均<0.05)。治疗后CHF患者的血浆AngⅡ、ET-1水平LVEF明显降低,而LVEF明显增高,差异均有统计学意义(t分别=28.78、9.82、5.49,P均<0.05)。Pearson相关分析显示,治疗前治疗组的血浆AngⅡ、ET-1水平均与LVEF呈负相关(r分别=-0.78、-0.69,P均<0.05);而AngⅡ与ET-1呈正相关(r=0.58,P<0.05)。结论高水平的AngⅡ和ET-1与CHF的发病密切相关;联合检测AngⅡ和ET-1可以作为评判慢性心衰预后的一项参考指标。

Objective To explore the change and clinical significance of angiotensinⅡ（AngⅡ） and endothelin-1（ET-1） in patients with congestive heart failure（CHF）.Methods Fifty CHF patients（study group） and 40 age-,gender-,body mass index（BMI）-matched healthy subjects（control group） were involved.The levels of plasma AngⅡ and ET-1 in two groups was analyzed and compared.Results Compared with the levels of plasma AngⅡ and ET-1 before the therapy,the levels of plasma AngⅡ and ET-1 in the study group were higher than that in the control group（t=37.59,21.83,P〈0.05）.The levels of plasma AngⅡ and ET-1 were significantly lower than that in the control group after the therapy（t=28.78,9.82,P〈0.05）,whereas left ventricular ejection fraction（LVEF） was significantly higher（t=5.49,P〈0.05）.Pearson correlation analysis displayed that the levels of plasma AngⅡ and ET-1 were negatively concerned with LVEF（r=-0.78,-0.69,P〈0.05）,whereas the level of plasma AngⅡ was positively concerned with ET-1（r=0.58,P〈0.05）.Conclusions The high levels of plasma AngⅡ and ET-1 might be participated in progress of CHF.Assay of variations of plasma AngⅡ and ET-1 levels in patients with CHF should be of importance as referred indexes.