高压氧对慢性充血性心力衰竭患者血浆内皮素-1和心功能的影响

Effect of high pressure oxygen on cardiac function and endothelin-1 in patient with congestive heart failure

目的探讨高压氧对慢性充血性心力衰竭(CHF)患者血浆内皮素-1(ET-1)和心功能的影响及临床意义。方法将75例CHF患者随机分组分为两组,对照组37例采用常规抗心力衰竭治疗,治疗组38例在上述基础上加用高压氧疗。观察并比较两组患者疗效,检测并比较两组的血浆ET-1、左室射血分数(LVEF)和二尖瓣血流最大流速E峰和A峰比值(E/A)变化。结果治疗组的总有效率明显高于对照组,差异有统计学意义(χ2=3.97,P<0.05)。治疗后治疗组的血浆ET-1水平与对照组比较,明显下降,而LVEF和E/A明显增高,差异均有统计学意义(t分别=6.74、2.93、11.42,P均<0.05);治疗组治疗后4周患者的血浆ET-1水平与治疗前比较,明显下降,LVEF和E/A明显增高,差异均有统计学意义(t分别=13.54、9.65、21.03,P均<0.05)。结论高压氧可明显降低CHF患者的血浆ET-1水平和改善心功能;血浆ET-1水平可以作为评判CHF患者预后的指标之一。

Objective To explore the impact of high pressure oxygen（HPO） on cardiac function and endothelin-1（ET-1） in patients with congestive heart failure（CHF）.Methods Seventy five patients with CHF were divided into control group（37 cases） and study group（38 cases） randomly.Cases in control group were given the routine therapy,whereas cases in study group were given the therapy of HPO besides the routine therapy.Efficacy and difference of levels of plasma ET-1,left ventricular ejection fraction（LVEF） and ratio of E and A peak of maximum peak of mitral velocity（E/A） were compared between the two groups.Results The total effective rate in study group were higher than that in the control group with significant difference（χ2=3.97,P0.05）.Compared with control group,the levels of plasma ET-1 in the study group were significantly lower after the therapy,whereas LVEF and E/A were significantly higher（t= 6.74,2.93,11.42,P0.05）.Compared with that before treatment,the levels of plasma ET-1 in the study group were significantly lower after 4 weeks treatment,whereas LVEF and E/A were significantly higher（t =13.54,9.65,21.03,P 0.05）.Conclusions The therapy of HPO might significantly lower the level of plasma ET-1 and improve cardiac function.The level of plasma ET-1 should be one of the important referred indexes for CHF patients.