慢性心力衰竭患者肾素-血管紧张素系统对纤溶功能的影响

Effect of renin-angiotens in system on fibrinolytic function in patients with chronic heart failure

目的 研究慢性心力衰竭 (CHF)患者肾素血管紧张素系统 (RAS)和纤溶功能的变化 ,及RAS对纤溶功能的影响。方法 CHF患者 6 0例。健康体检者 2 0例 (正常对照组 )。用放射免疫法 (RIA)测定CHF组和对照组血浆肾素活性 (PRA)、血管紧张素Ⅱ (AngⅡ )、醛固酮 (ALD)水平 ,并用酶联免疫吸附法 (ELISA)测定血浆组织型纤溶酶原激活物 (t PA)、纤溶酶原激活物抑制物 1(PAI 1)抗原含量。结果 CHF组血浆PRA、AngⅡ、ALD、t PA和PAI 1平均水平都明显高于对照组 (P <0 .0 1)。CHF患者血浆PAI 1和AngⅡ水平增高程度随心力衰竭恶化而愈加明显。CHF患者血浆PAI 1抗原含量与AngⅡ水平呈正相关 (r=0 .994 ,P<0 .0 1)。

Objective To investigate the changes of renin-angiotensin system (RAS) and fibrinolytic function in patients with chronic heart failure (CHF), and to explore the effect of RAS on fibrinolytic function in patients with CHF. Methods Sixty patients with CHF were included in the CHF group, while 20 normal subjects were selected in the normal control (NC) group. The plasma levels of plasma renin activity (PRA), angiotensin Ⅱ (AngⅡ) and aldosterone (ALD) were measured in the CHF group and the NC group by radio immunoassay(RIA). The concentrations of plasma tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) antigen were simultaneously measured by enzyme-linked immunosorbent assay(ELISA). Results The mean levels of plasma PRA, AngⅡ, ALD, t-PA and PAI-1 in the CHF group were significantly higher than those in the NC group (P< 0.01). The more severe the heart failure was, the more marked increases were shown in the levels of plasma PAI-1 and AngⅡ in patients with CHF. There was a positive correlation between plasma PAI-1 antigen concentrations and AngⅡ levels in patients with CHF(r= 0.994, P< 0.01). Conclusion RAS might contribute to regulate the endogenous fibrinolytic function during the development of the CHF.