福辛普利对老年冠心病患者内皮素-1及血管内皮依赖性舒张功能的影响

Effects of fosinopril on serum endothelin-1 and endothelium-dependent dilative function in elderly patients with coronary heart disease

目的 通过检测患者的内皮素 1(ET 1)浓度及肱动脉对加压刺激的舒张性反应 ,观察福辛普利对老年冠心病患者ET 1及血管内皮依赖性舒张功能的影响。 方法 选择 4 6例老年冠心病患者及 2 8例健康老年人作对照组 ,测定福辛普利 (5～ 10mg)治疗前后患者血浆ET 1浓度及肱动脉对加压刺激的舒张性反应 ,与治疗后及对照组进行比较。 结果 治疗前冠心病患者ET 1水平〔(117 5± 12 0 )ng/L〕较对照组〔(76 2± 10 8)ng/L〕高 (P <0 0 1) ,肱动脉对加压刺激产生舒张性反应而致内径增加 ,其内径增加率为 (4 2± 2 7) % ,较对照组 (2 2 4± 4 9) %降低 (P <0 0 1) ;经福辛普利治疗 6个月后 ,患者ET 1下降为 (93 5± 9 7)ng/L ,肱动脉内径增加率为 (18 0± 3 0 ) % ,与治疗前比较差异有显著性 (P <0 0 5 )。 结论 福辛普利治疗老年冠心病可降低患者血浆ET 1水平及改善患者的血管内皮依赖性舒张功能。

Objective In order to investigate the serum endothelin-1 (ET-1) and the endothelium-dependent dilative function in elderly patients with coronary heart disease(CHD) and the effects of fosinopril on ET-1 and endothelium-dependent dilative function. Methods Forty-six patients and 28 healthy elderly subjects were included in this study. The levels of ET-1 and endothelium-dependent dilative reaction of brachial artery to overpressure measured by Color Doppler Ultrasonic in elderly CHD group after treatment with fosinopril were compared with those before treatment and those in control group, respectively. Results The levels of ET-1 in CHD group was significantly higher than those of the control group 〔(117.5±12.0) ng/L vs (76.2±10.8) ng/L, P<0.01〕, the diameter of brachial artery was increased due to its reaction to overpressure-infusion reaction, while the increased rate was lower〔(4.2±2.7) % vs (22.4±4.9) %, P<0.01〕. After therapy with fosinopril for half year, the concentration of serum ET-1 decreased to〔 (93.5±9.7) ng/L,P<0.05 〕. The increasing rate of branchial artery diameter rose to (18.0±3.0)%,P<0.01. Conclusions The concentration of ET-1 decreased and the endothelium-dependent dilative function was improved by fosinopril in elderly patients with coronary heart disease.