摘要
目的 研究内皮功能不全与慢性心力衰竭的关系 ,并探讨不同剂量培哚普利在心力衰竭治疗中对内皮素(ET)和一氧化氮 (NO)的不同影响。方法 对慢性心力衰竭患者 74例 (其中NYHAⅡ级 2 8例、Ⅲ级 2 4例、Ⅳ级 2 2例 )和 2 4例正常对照者 ,分别测定基础血浆ET值和血浆中NO值 ,心力衰竭患者随机分成小剂量培哚普利组与较大剂量组 ,治疗 8周后 ,再次测定ET值和血NO值。结果 血浆中ET、NO含量随着心衰的严重程度而逐渐增高 ,与Boston心衰积分 (BSS)呈正相关 (P <0 .0 0 1 ) ,与左室射血分数 (LVEF)呈负相关 (P <0 .0 0 1 ) ;经抗心衰治疗后两组患者ET、NO显著降低 (P <0 .0 1 ) ,其中较大剂量组治疗后ET、NO较小剂量组明显降低 (P <0 .0 1 )。结论 内皮功能损害与心力衰竭的严重程度密切相关 ,较大剂量的血管紧张素转换酶抑制剂 (ACEI)能显著降低ET、NO ,更好的改善心力衰竭。
Objective To study the correlation of endothelial dysfunction in patients with chronic heart failure and to explore the effect on endothelin (ET) and nitric oxide(NO) with various doses of perindopril.Methods Seventy-four patients with heart failure (NYHA I 28 patients,NYHA II 24 patients,NYHA Ⅳ 22 patients) were randomly divided into low-dose and high-dose perindopril groups.The levels of ET and NO were measured just before and 8 weeks after therapy.24 healthy subjects were selected as control group.Results The levels of ET and NO showed a positive correlation with the severity of heart failure and Boston scoring system(BSS) (P<0.001) and a negative correlation with the left ventricular ejection fraction(LVEF)(P<0.001).The levels of ET and NO were reduced after therapy in both groups( P<0.01).The levels of ET and NO with high-dose group were obviously lower than those with low-dose group(P< 0.01).Conclusion The endothelial dysfunction was correlated with the severity of chronic heart failure.The high-dose angiotensin converting enzyme inhibitor can obviously reduce the levels of ET and NO.The high-dose group had a better effect on the improvement of the heart failure.
出处
《同济大学学报（医学版）》
CAS
2004年第6期500-502,共3页
Journal of Tongji University(Medical Science)
关键词
慢性心力衰竭
内皮功能不全
内皮素
一氧化氮
血管紧张素转换酶抑制剂
chronic heart failure
endothelial dysfunction
endothelin
nitric oxide
angiotensin converting enzyme inhibitor
Perindopril
