慢性心力衰竭患者组织因子和血管紧张素Ⅱ的关系及不同剂量福辛普利干预的疗效  

Plasma tissue factor and serum angiotensin Ⅱ and the therapeutic effect of different dosages of fosinopril on chronic heart failure

作　　者：马琦琳[1] 杨丽洁 杨天崙[1] 孙明[1] 吴声滨[1] 宁阳根[1] 

机构地区：[1]中南大学湘雅医院心内科,长沙410008

出　　处：《中南大学学报（医学版）》2009年第5期448-452,共5页Journal of Central South University ：Medical Science

摘　　要：目的:分析慢性心力衰竭(chronic heart failure,CHF)患者血浆组织因子(tissue factor,TF)和血清血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)的关系,并探讨不同剂量福辛普利对慢性心力衰竭患者的影响。方法:选择30例健康者作正常对照组,35例慢性心力衰竭患者为心力衰竭组,并随机分为常规剂量福辛普利组(10mg每天1次)和中剂量福辛普利组(10mg每天2次),分别在入院时和治疗后10周时检测TF和AngⅡ水平变化;以彩色超声心动图检查左室射血分数(left ventricular ejection fractions,LVEF)和左心室收缩末期容量指数(left ventricular endsystolic volume index,LVESVI)。结果:与正常对照组相比,慢性心力衰竭患者LVESVI,TF及AngⅡ水平明显升高(P<0.01),LVEF值明显降低(P<0.01)。心力衰竭患者TF与AngⅡ呈正相关(r=0.2491,P<0.01)。常规、中剂量福辛普利组治疗后LVESVI,TF及AngⅡ水平较治疗前均有下降(P<0.05或P<0.01),LVEF较治疗前均明显增高(P<0.05或P<0.01),且中剂量组治疗后上述改变更显著(P<0.01)。结论:心力衰竭患者TF与AngⅡ呈正相关关系;福辛普利具有改善心力衰竭患者心功能、对抗血栓前状态的作用,且随着剂量的增加疗效更显著。Objective To determine the relation between plasma tissue factor （TF） and serum angiotensin Ⅱ （ Ang Ⅱ ） and the effect of different dosages of fosinopril on chronic heart failure （CHF）. Methods Thirty healthy controls and 35 CHF patients were recruited to observe Ang Ⅱ , TF, left ventricular ejection fractions （LVEF） and left ventrieular end-systolic volume index （LVES- Ⅵ ） at baseline and 10 weeks after the treatment. The 35 patients were randomly assigned into 2 groups： A routine dosage fosinopril group received 10 mg once daily and a middle dosage group received 10 mg twice a day for 10 weeks. Results Compared with the healthy controls, Ang Ⅱ , TF, and LVESVI significantly increased （ P 〈 0.01 ） and LVEF significantly decreased （ P 〈 0. 01 ） in CHF patients. The TF was positively correlated with Ang Ⅱ （ r = 0. 2491 , P 〈 0.01 ） in the patients. After the 10-week treatment with different dosages of fosinopril, Ang Ⅱ , TF, and LVESVI ob-viously decreased （ P 〈 0.05 or P 〈 0. 01 ） and LVEF significantly increased in the 2 groups （ P 〈 0. 05 or P 〈0. 01 ）. The middle dosage group changed more than the routine dosage group （P 〈 0.01 ）. Conclusion TF is positively correlated with Ang Ⅱ in CHF patients. Fosinopril can greatly improve cardiac function and antagonize prethrobotic state, and the therapeutic effect improves with the dosage increase.

关 键 词：慢性心力衰竭 组织因子 血管紧张素Ⅱ 福辛普利 

分 类 号：R541.6[医药卫生—心血管疾病]