摘要
目的探讨血管紧张素转换酶抑制剂(ACEI)培哚普利干预对心力衰竭(HF)患者血浆血管紧张素Ⅱ(AngⅡ)水平和纤溶活性指标的影响。方法52例HF患者随机分成培哚普利组27例和常规治疗组25例,培哚普利组在常规治疗基础上加用培哚普利4mg/d。入院后当天和治疗2周后采血检测血浆AngⅡ和纤溶酶原激活物抑制物-1(PAI-1)含量、活性和组织纤溶酶原激活剂(tPA)活性。选择20例正常人作为正常对照。结果与正常对照组比较,HF患者血浆AngⅡ水平、PAI-1含量和活性升高,tPA活性降低(P均<0.01)。HF患者血浆AngⅡ水平与PAI-1含量和活性呈正相关(r分别为0.6572和0.7044,P均<0.01),与tPA活性无相关性(r=-0.3981,P>0.05)。治疗2周后,培哚普利组AngⅡ水平、PAI-1含量和活性较治疗前降低(P均<0.01),tPA活性升高(P<0.01);常规治疗组治疗前后上述指标无变化。结论HF患者体内纤溶系统功能失衡,呈高凝状态,ACEI可改善其纤溶活性,对降低HF患者血栓栓塞性疾病的发生可能有重要意义。
Aim：To investigate the changes of plasma level of angiotensin Ⅱ （AngⅡ） and fibrinolytic activity and the effects of perindopril on them in patients with heart failure （HF）. Methods： Fifty-two patients with HF were randomized into perindopril group （n =27） and routine treatment group （n =25）. Perindopril group received pefindopril （4 rag/d） in addition to routine treatment. Plasma level of AngⅡ, mass concentration and activity of plasminogen activitor inhibitor type-1 （ PAI- 1 ）, activity of tissue plasminogen activator （tPA） were measured before and 2 weeks after treatment. Twenty healthy persons were selected as normal control. ReSults ： Compared with normal control, plasma level of AngⅡ,mass concentration and activity of PAI-1 were higher （ P 〈 0.01 ）, activity of tPA was lower （ P 〈 0.01 ） in patients with HF. There was a positive correlation between level of AngⅡ and mass concentration or activity of PAI-1 （ r = 0.657 2,0. 704 4, respectively, P 〈 0.01 ）, but no correlation between level of AngⅡ and activity of tPA （ r = - 0. 398 1, P 〉 0.05 ）. Compared with those before treatment, plasma level of AngⅡ, mass concentration and activity of PAI-1 significantly decreased, activity of tPA significantly increased in the perindopril group,but they did not change in the routine treatment group. Conclusion： It is suggested that the endogenous fibrinolytic system is unbalanced in patients with HF. Angiotensin converting enzyme inhibitors can improve the fibfinolytic ac tivity, and it may play an important role in reducing the risk of thromhoemholic events in HF patients.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2006年第2期331-333,共3页
Journal of Zhengzhou University(Medical Sciences)
