依那普利治疗充血性心力衰竭及对内皮素、肾素血管紧张素系统的影响

The Effects of Enalaprol on Congestive Heart Failure and Its Impacts on Endothelins,Renin-angiotensin-system

目的 探讨应用依那普利对充血性心力衰竭 (CHF)患者的治疗效果及对血浆内皮素 (ET)和肾素 血管紧张素系统 (RAS)的影响。方法 6 0例冠心病CHF患者随机分为依那普利加常规治疗组 (治疗组 )和常规治疗组 (对照组 ) ,两组在治疗前及治疗 6个月后分别测定射血分数 (EF)、左室短轴缩短率 (FS)、每搏输出量(SV)、舒张早期最大充盈速度 (E)及与舒张晚期最大充盈速度 (A)的比值 (E A)、血浆ET、血浆肾素活性 (PRA)、血管紧张素Ⅱ (ATⅡ )和醛固酮 (ALD)水平并观察其变化。结果 ①治疗后治疗组及对照组EF(% ) ,FS(% ) ,SV(V ml) ,E(v m·s-1) ,E A组间比较差异均有显著性 (P <0 .0 5 )。②治疗组治疗前后ET ,PRA ,ATⅡ ,ALD各项指标之间差异均非常显著 (P <0 .0 1) ,对照组治疗前后以上各指标均无明显变化 (P >0 .0 5 )。结论 依那普利长期口服可抑制CHF患者RAS的过度激活 ,逆转血管内皮功能不全 ,从而阻断CHF恶化过程 ,改善心脏收缩。

Objective Methods 60 cases of coronary heart disease were randomly divided into enalaprol.To study the effects of enalaprol on congestive heart failure(CHF) in patients with coronary heart disease and its impacts on endothelins (ET),renin angiotensin aldosterone system (RAS).Methods 60 cases of coronary heart disease were randomly divided into enalaprol group based on regular treatment and regular treated group(control group),prior to treatment and 6 months later the following as indicator were measured in both groups ,ejection fraction(EF),percent fractional shortening(FS),stroke volume(SV),diastole early phase maximum filling velocity(E)/diastole late phase maximum filling velocity(A)(E/A),the level of plasma ET,plasma renin activity(PRA),angiotensin Ⅱ(ATⅡ)and aldosterone(ALD).Results ①All indicators were obviously ameliorated in both of groups,and the EF(%),FS(%),SV(V/ml),E(v/m·s -1 ),E/A were significantly higher in treated groups comparing with control groups(P<0.05);②After treatment,ALD,the ET,PRA,ATⅡ,ALD were significantly changed in enalaprol treated group respectively(P<0.01)while all the indicators were not obviously ameliorated in control group.Conclusion By inhibiting renin angiotensin aldosterone system and reversing endothelial dysfunction,enalaprol can significantly ameliorate heart funtion of patients with heart failure.