风湿性心脏病合并心衰患者血浆内皮素变化及卡托普利影响

目的：探讨风湿性心脏病合并充血性心力衰竭（RHD－CHF）患者血浆内皮素（ET）含量变化及卡托普利对其影响。方法：检测26例RHD－CHF患者及10位正常人血浆ET含量，并将患者随机分为两组：实验组（n=13)，口服卡托普利18．75－37．5mg/d，连服4－6周；对照组（n=13）服用安慰剂，测两组治疗前后ET浓度。结果：RHD－CHF患者血浆ET含量明显高于正常对照组（P＜0．01），并与心衰严重程度有关。心功能Ⅳ级明显高于心功能Ⅱ、Ⅲ级；口服卡托普利组，血浆ET浓度明显低于对照组（P＜0．05）且低于治疗前水平。结论：ET升高是RHD－CHF患者的病理生理特征之一，ET参与了CHF发病及病理生理过程，卡托普利能抑制上述这种改变。

The Variation of Plasma Endothelin in Patients of Rheumatic Heart Disease with Chronic Heart Failure and Therapeutic Effect of Captopril

Objective: To study the variation of plasma endothelin (ET) level in patients of rheumatic heart disease (RHD) with chronic heart failure (CHF) and therapeutic effect of captopril. Methods: Plasma endothelin levels were measured in 26 patients of rheumatic heart disease with chronic heart failure, then randomly devided into two groups. The treated group(n = 13) took oral captopril 18.7-37.5mg/day for 4-6weeks; the control group (n =13) took placebo. Results: 1. Plasma en-dothelin levels RHD-CHF patiencs were significantly higher than those in normal control group (P<0.01), and plasma ET levels were related to grades of heart function. 2. The levels of plasma ET in treated group were sighificantly lower than those in control group and lower than those before treatment. Conclusion: The increase of plasma ET is one of the features of patho-physiology in patients of rheumatic heart disease with chronic heart failure. Plasma ET plays an important role in the formation and development of CHF. Captopril can inhibit this change.