硝普钠联合硝酸甘油治疗急性心力衰竭的疗效及对血浆Ang Ⅱ,NO,ET-1,Cys-C的影响  

Effects of Sodium Nitroprusside and Nitroglycerin on Plasma Ang Ⅱ,NO,ET-1,Cys-C in Patients with Acute Heart Failure

作　　者：李敏 李虎[1] 王逵 黄金燕 薛旺 欧东波[1] 曾莉君 林尧明 朱玉峰 LI Min, LI Hu,Wang Kui, Huang Jinyan,Xua Wang,Ou Dongpo,Zeng Lijun, Lin Yaoming,Zhu Yufeng(The No.422 Hospital of PLA,Zhanjiang 524005,Guangdong, Chin)

机构地区：[1]中国人民解放军第四二二医院,广东湛江524005

出　　处：《中西医结合心脑血管病杂志》2018年第3期330-333,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨硝普钠联合硝酸甘油治疗急性心力衰竭的疗效及对血浆血管紧张素Ⅱ(AngⅡ)、一氧化氮(NO)、内皮素-1(ET-1)、胱抑素-C(Cys-C)的影响。方法选择我院2014年12月—2016年12月收治的102例急性心力衰竭病人作为研究对象,按抽签法分为对照组和研究组,每组51例。对照组采用硝酸甘油治疗,研究组采用硝普钠治疗。观察并比较两组临床疗效,血浆AngⅡ,NO,ET-1,Cys-C水平、心率及、血压、不良反应。结果治疗后,研究组总有效率92.16%,显著高于对照组的74.51%,差异有统计学意义(P<0.05)。治疗后,两组血浆AngⅡ,ET-1,Cys-C水平,心率及血压均较治疗前显著下降,研究组血浆AngⅡ,ET-1,Cys-C明显低于对照组,差异有统计学意义(P<0.05),但心率及血压比较无统计学意义(P>0.05);两组NO均较治疗前明显上升,研究组显著高于对照组(P<0.05)。两组不良反应发生率比较无统计学意义(P>0.05)。结论硝普钠联合硝酸甘油治疗急性心力衰竭的疗效优于硝酸甘油单用,能够抑制血浆AngⅡ、ET-1、Cys-C表达,提高NO水平,缓解血管内皮功能,促进病人恢复。Objective To investigate the effects of sodium nitroprusside and nitroglycerin on plasma angiotensinⅡ（AngⅡ）,nitric oxide（NO）,endothelin-1（ET-1）,cystatin-C（Cys-C）in patients with acute heart failure.Methods One hundred and two patients with acute heart failure from December 2014 to December 2016 were randomly divided into two groups：control group（n =51）treated with nitroglycerin,and treatment group（n =51）treated with sodium nitroprusside and nitroglycerin.The clinical efficacy,the levels of plasma AngⅡ,NO,ET-1,Cys-C,heart rate,blood pressure,adverse reactions were observed.Results After treatment,the total clinical effective rate was significantly higher in treatment group than that in control group（P 〈0.05）.The levels of plasma AngⅡ,ET-1,Cys-C,heart rate and blood pressure were significantly decreased in two groups.The levels of plasma AngⅡ,ET-1,Cys-C were significantly lower in treatment group than that in control group（P 〈0.05）.The plasma NO level was increased in two groups,which was higher in treatment group than that in control group（P 〈0.05）.There was no significant difference in the incidence of adverse reactions between two groups（P 〉0.05）.Conclusion Sodium nitroprusside and nitroglycerin can restrain the expression of plasma AngⅡ,ET-1,Cys-C,improve the level of NO,relieve vascular endothelial function in patients with acute heart failure,which is better than nitroglycerin alone.

关 键 词：急性心力衰竭 硝普钠 硝酸甘油 血管紧张素Ⅱ 一氧化氮 内皮素-1 胱抑素-C 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]