氯沙坦对充血性心衰患者心功能及循环NO/ET的影响  

Effect of losartan on cardiac function and secretion of nitric oxide andendothelin in patients with congestive failure

作　　者：王邦宁[1] 张传焕[1] 沈玉芳[1] 刘敏[1] 陈大年[1] 高丹屏[1] 

机构地区：[1]安徽医科大学第一附属医院,ccu合肥230022

出　　处：《中国临床药理学与治疗学》2001年第1期56-58,共3页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的探讨氯沙坦治疗充血性心衰 (CHF)的临床疗效及对循环NO和内皮素 (ET)水平的影响。方法60例CHF患者在常规治疗基础上随机加用氯沙坦(25～50mg·d -1 ,口服 )或依那普利 (2.5～5mg·d -1 ,口服 ) ,疗程12wk。观察治疗前后心功能、血浆NO及ET水平变化。30例健康者作为正常对照组。结果CHF患者收缩和舒张功能参数异常 ,血浆ET及NO水平较正常对照组显著升高 (P<0.05或P<0.01)。治疗12wk后 ,氯沙坦组心功能改善率为85 % ,依那普利组改善率为84 % ,心脏收缩和舒张功能参数均显著改善 ;血浆ET及NO水平明显降低 (P<0.01) ,NO/ET比值显著升高(P<0.05),两组间差异无统计学意义 (P>0.05)。结论氯沙坦能明显改善CHF患者心脏功能 ,恢复NO与ET之间合成释放平衡 。Aim To evalute the effects of losartan on the cardiac function and secretion of nitric oxide(NO)and endothelin(ET)in patients with congestive heart failure(CHF).Methods Sixty patients with class Ⅱ～Ⅳ CHF were randomised to receive a 12 weeks of routine therapy either with losartan(n=30)to be added from 25 mg to 50 mg daily or with enalapril(n=30)to be added from 2.5 mg to 5 mg daily. The cardiac systolic and diastolic funtion and the levels of NO and ET were observed before and after therapy respectively, with 30 normal control subjects seving as control. Results The abnormal cardiac systolic and diastolic function parameter were present in patients with CHF. The ET and NO levels in CHF patients were significantly higher than those in the control group(P<0.05).NYHA function class was improved in 85% of losartan_treated patients and in 84% of enalapril_treated patients after 12 weeks,as compared with cardiac function at baseline. ET and NO levels were significantly reduced(P<0.01),NO/ET ratio was increased(P<0.05) after 12 weeks of therapy in two active groups. Conclusion The systolic and diastolic functions of patients with CHF are greatly improved by losartan treatment,which reverses the imbalance of NO/ET and it is suspected that this action may be another important mechanism of its treating heart failure.

关 键 词：氯沙坦 充血性心力衰竭 内皮素 一氧化氮 

分 类 号：R972.1[医药卫生—药品] R541.61[医药卫生—药学]