地高辛对充血性心力衰竭患者血浆去甲肾上腺素和血管紧张素Ⅱ含量及相关性的影响

目的 :观察地高辛对充血性心力衰竭 (Congestiveheartfailure ,CHF)患者神经体液因素的影响及相关性 ,以探讨地高辛在治疗CHF患者中的作用机制并评价疗效。方法 :选用地高辛治疗中、重度 (NY HA心功能分级Ⅲ、Ⅳ级 )CHF患者 2 5例。治疗前、后采用荧光分析及放免分析法分别测定血浆去甲肾上腺素 (Norepinephrine ,NE)及血管紧张素Ⅱ (AngiotensinⅡ ,AngⅡ )的水平。 结果 :( 1)地高辛治疗后血浆NE及AngⅡ分别由治疗前的 2 91pg± 80 pg/ml及 73pg± 60pg/ml下降至 2 13pg± 82pg/ml及 3 6pg± 17pg/ml(P均 <0 .0 1)。( 2 )地高辛治疗后两者的下降幅度有较好的相关性 (r =0 .644,P <0 .0 1)。血浆NE、AngⅡ基础水平与治疗后下降幅度也呈较好的相关性(r分别为 0 .60及 0 .93 ,P分别 <0 .0 1)。结论 :地高辛能明显改善中、重度CHF患者心功能和神经体液明显异常 ,抑制CHF患者NE和AngⅡ活性

Effects of Digoxin on Plasma Level and relationship of Norepinephrine and Angiotensin Ⅱ in Patients with Congestive Heart Failure

To observe the effects and relationships of digxin on neurohormonal factors among patients with congestive heart failure (CHF),the mec hanisms of action and evaluation of therapy of digoxin were studied in the patie nts with CHF.Method: Plasma levels of Norepinephrine (NE) and Angiotensin Ⅱ (Ang Ⅱ) was measured in 25 patients with moderate to severer CHF,using fluorosp ectrophotometry and radiooimmunoassay analysis during digoxin therapy.Results: (1) After digoxin therapy,plasma levels of NE and Ang Ⅱ decreased significantly from 291±80 pg/ml and 73±60 pg/ml to 213±82 pg/ml and 36±17 pg/ml respectively( P <0.01).(2) A significant corre lation was found between the change in plasma NE and AngⅡlevels during digoxin therapy( r=0.644,P <0.01).In addition,there was an appreciable correlation bet ween baseline plasma NE and the changes in NE during digoxin therapy( r=0.60,P <0.01).Similar but stronger correlation was found between baseline AngⅡ and t he changes in AngⅡ levels during digoxin therapy( r=0.93,P <0.01).Conclusion: These results indicated that a significant improveme nt in hemodynaamics was observed with digoxin therapy in patients with moderate to severe CHF,and digoxin could inhibit NE and AngⅡ activity in patients wit h CHF,as soon as plasma levels of NE and AngⅡ decreased significantly with dig oxin cherapy.