螺内酯对扩张型心肌病心力衰竭患者某些体液因子的影响

The effect of spironolactone on some neurohormonal factors in patients suffering cardiac insufficiency secon-dary to dilated cardiomyopathy

目的 :探讨螺内酯对扩张型心肌病心力衰竭患者血浆儿茶酚胺、肾素活性、血管紧张素Ⅱ及醛固酮的影响。方法 :入选 2 0例扩张型心肌病心力衰竭患者 ,随机分入螺内酯组与对照组 ,各 10例 ,用螺内酯治疗前与治疗 1个月后 ,用高效液相色谱方法测定血浆去甲肾上腺素、肾上腺素 ,同时采用均相竞争放射免疫方法检测血浆肾素活性、血管紧张素 Ⅱ与醛固酮。结果 :治疗 1个月后螺内酯组血浆去甲肾上腺素、肾上腺素、肾素活性及醛固酮明显低于治疗前 ,也低于对照组。结论 :螺内酯可明显抑制扩张型心肌病心力衰竭患者的儿茶酚胺水平 ,降低肾素活性及醛固酮 。

Objective:To determine the effects of spironolactone on neurohormonal factors,catecholamine,plasma renin activity,angiotensin Ⅱ and aldosterone in patients with cardiac insufficiency secondary to dilated cardiomyopathy.Method:Twenty cases suffering cardiac insufficiency secondary to dilated cardiomyopathy were selected and randomly enrolled into two groups,spironolactone group and control group,10 cases in each group.High\|pressure liquid chromatograph(HPLC)was used to detect plasma norepinephrine and adrenaline,plasma renin activity,angiotensin Ⅱ and aldosterone were also analysed by RIAs.Result:Plasma norepinephrine,adrenaline,plasma renin activity and aldosterone in spironolactone group after 1 month treatment were significantly lower than that of the same group before spironolactone treatment and that of control group after 1 month routine therapy.Conclusion:Spironolactone can signifcantly decrease plasma norepinephrine,adrenaline,plasma renin activity and aldosterone in dilated cardiomyopathy patients,these changes may be important mechanisms of spironolactone which could improve the prognosis of congestive heart failure. [