摘要
目的 :探讨慢性心力衰竭时血流动力学、肾素活性、血管紧张素Ⅱ和醛固酮变化及氯沙坦对其影响。方法 :慢性心力衰竭患者 60例随机分为氯沙坦组和依那普利组 ,每组 3 0例 ,疗程 12周。测定治疗前、治疗 1、12周血浆肾素活性、血管紧张素Ⅱ、醛固酮和治疗前、治疗 12周心功能、血流动力学变化。 3 0例健康体检者作对照组。结果 :60例慢性心力衰竭患者血浆肾素活性、血管紧张素Ⅱ和醛固酮水平均较对照组升高 (P <0 0 1) ,氯沙坦组治疗后 1、12周血浆肾素活性、血管紧张素Ⅱ水平较治疗前升高 ,以 1周升高明显 (P <0 0 5 ) ,而 12周与治疗前比较差异无显著性 (P >0 0 5 ) ,醛固酮水平治疗后 1、12周与治疗前比较则降低 ,有显著差异 (P <0 0 1)。依那普利组治疗 1周、12周血浆血管紧张素Ⅱ、醛固酮水平较治疗前降低 (P <0 0 1) ,而肾素活性水平则升高 ,以 1周升高明显 (P <0 0 5 ) ,而 12周与治疗前比较差异无显著性 (P >0 0 5 ) ,治疗前后两组间比较差异无显著性 (P >0 0 5 )。氯沙坦组和依那普利组在治疗 12周后 ,多项血流动力学指标与本组治疗前比较均有改善 (P <0 0 5 )。结论 :慢性心力衰竭患者血流动力学异常、肾素—血管紧张素—醛固酮系统激活是心力衰竭病理生理特征之一 ,氯沙坦治疗后可获?
Objective: To study the effects of losartan on hemodynamics, plasma renin activity(RA),and angiotensinⅡ(AngⅡ)or aldosterone(ALD)level in patients with chronic heart failure(CHF). Methods:Sixty patients with CHF were randomised to either losartan or enalapril .Plasma RA,AngⅡand ALD concentrations were assessed by radioimmunnoassay.Hemodynamics was assessed by echocardiography. Results: Plasma RA,AngⅡand ALD levels were higher in patients with CHF than those in the normal subjects(p<0.01).Hemodynamics and abnormal cardiac function were present in patients with CHF.Plasma ALD was reduced after therapy in both groups(p<0.05).Hemodynamics and abnormal cardiac function were improved 12 weeks after treatment in both groups(p<0.05). Conclusion:CHF is characterized by activation of the renin-angiotensin-aldosterone system,and abnormal hemodynamics.This study shows that oral losartan administered to CHF patients results in beneficial clinical,hemodynamic and neurohormonal effects,and it is well tolerated.
出处
《中国循环杂志》
CSCD
北大核心
2004年第3期198-201,共4页
Chinese Circulation Journal
