卡托普利对心力衰竭患者QT离散度及血浆AngⅡ,TXB_2,6-keto-PGF_(1α)影响

Effect of captopril on QT dispersion and the plasma levels of AngⅡ,TXB_2,6-keto-PGF_(1α) concentration in chronic congestive heart failure

目的 :探讨卡托普利治疗慢性充血性心力衰竭 (CHF)对肾素 -血管紧张素系统和前列腺素系统及 QT离散度 (QTd)的影响。方法 :用放射免疫法测定 40例 CHF患者卡托普利治疗 2周前后血浆 Ang ,TXB2 ,6 - keto- PGF1α浓度 ;手工测量同步 12导联心电图 QTd。结果 :1卡托普利治疗 2周后 QTd无明显变化 ;2血浆 Ang ,TXB2 浓度和 TXB2 /6 - keto- PGF1α比值明显下降 ;6 - keto- PGF1α水平显著升高 ;3血浆 TXB2 的降低与 6 - keto- PGF1α的升高呈负相关 (r=- 0 .5 9,P<0 .0 1) ;平均动脉压的下降与 6 - keto- PGF1α的升高呈正相关 (r=0 .41,P<0 .0 5 )。结论 :卡托普利 2周治疗有利于恢复心力衰竭患者体液内环境的稳定 ;但对 QTd无显著影响。

AIM: To study the effects of captopril on QTd and plasma levels of AngⅡ,TXB_2,6-keto-PGF_ 1α in patients with chronic congestive heart failure(CHF). METHODS: Forty patients with CHF treated with captopril were observed. Two weeks later,the QT interval was measured in synchrony 12 leads ECG,the levels of plasma AngⅡ,TXB_2,6-keto-PGF_ 1α were measured by radioimmunoassay. RESULTS:①The QTd was not significantly decreased after treated with captopril for two weeks. ②The levels of plasma AngⅡ,TXB_2 and the ratio of TXB_2/6-keto-PGF_ 1α were significantly decreased,while the levels of plasma 6-keto-PGF_ 1α were significantly increased (P<0.01,respectively). ③The decrease of TXB_2 was inversely related to the increase of 6-keto-PGF_ 1α (r=-0.59,P<0.01); and that of mean artery pressure was positively related to the increase of 6-keto-PGF_ 1α (r=0.41,P<0.05). CONCLUSION:After using for two weeks,captopril can recover circulatory homeostasis in patients with CHF,but has no effect on QTd.