摘要
目的 :评价L 精氨酸对心力衰竭 (心衰 )患者血管内皮功能的影响。方法 :应用高分辨率超声诊断仪 ,评估 40例心衰患者和 3 0例健康者 (正常对照组 )的内皮依赖性血管舒张功能和非内皮依赖性血管舒张功能 ,并测定血浆一氧化氮、内皮素 1(ET 1)浓度。 40例心衰患者被随机分为 2组 ,每组 2 0例 ,分别予以 2 0 %L 精氨酸注射液 10 0ml(L 精氨酸治疗组 )和 5 %葡萄糖注射液 10 0ml(安慰剂组 ) ,均在 60min内恒速静脉滴注。随即再次评估内皮依赖性血管舒张功能和非内皮依赖性血管舒张功能 ,同时复测血浆一氧化氮和ET 1浓度。结果 :与正常对照组相比 ,心衰患者内皮依赖性血管舒张功能显著受损 (P <0 0 1) ,非内皮依赖性血管舒张功能无明显变化 (P >0 0 5 )。血浆一氧化氮浓度下降 ,ET 1浓度上升 (P均 <0 0 1)。L 精氨酸治疗组内皮依赖性血管舒张功能得到明显改善 (P <0 0 5 ) ,非内皮依赖性血管舒张功能无变化 (P >0 0 5 ) ,血浆一氧化氮浓度升高 ,ET 1浓度下降 (P均 <0 0 5 )。而安慰剂组均无显著变化 (P >0 0 5 )。结论 :L 精氨酸能改善心衰患者血管内皮功能。
Objective: To evaluate the effect of L-arginine on endothelial function in patients with chronic heart failure(CHF). Methods: Endothelium-dependent and endothelium-independent vasorelaxation of the brachial artery was assessed at baseline in 40 patients with CHF and 30 controls by high-resolution ultrasound. Plasma nitric oxide(NO) and endotheln-1(ET-1)were detected. Forty patients with CHF were randomized to receive 20% L-arginine 100 ml (n=20),or 5% glucose 100 ml (n=20) by intravenous infusion for 60 minutes at constant rate. Endothelium-dependent and endothelium-independent vasorelaxation, plasma NO and ET-1 were detected. Results: Compared with normal controlsr〔(6.7±3.4)%〕,endothelium-dependent vasorelaxation was impaired in all 40 CHF patients 〔(3.1±2.1)%, P<0.01〕. NO changes in endothelium-independent vasorelaxation were found.CHF patients had decreased NO (p<0.01)and increased ET-1(p<0.01).In comparison with the baseline, endothelium-dependent vasorelaxation was significantly improved after treatment with L-arginine 〔(3.0±1.9)%vs(5.9 ±2.5)%,p<0.05〕.NO was increased (p<0.05) but ET-1 decreased(p<0.05).No significant changes were found in placebo group (p>0.05). Conclusion: L-arginine can improve the endothelial function in patients with CHF.
出处
《中国循环杂志》
CSCD
北大核心
2003年第2期135-137,共3页
Chinese Circulation Journal
