慢性心力衰竭患者组织因子和血管紧张素Ⅱ的关系及不同剂量福辛普利干预的疗效

目的：分析慢性心力衰竭（chronic heart failure， CHF）患者血浆组织因子（tissue factor，TF）和血清血管紧张素Ⅱ（angiotensin Ⅱ，AngⅡ）的关系，并探讨不同剂量福辛普利对慢性心力衰竭患者的影响。方法：选择30例健康者作正常对照组，35例慢性心力衰竭患者为心力衰竭组，并随机分为常规剂量福辛普利组（10 mg 每天1次）和中剂量福辛普利组（10 mg 每天2次），分别在入院时和治疗后10周时检测TF和AngⅡ水平变化；以彩色超声心动图检查左室射血分数（left ventricular ejection fractions,LVEF）和左心室收缩末期容量指数（left ventricular end-systolic volume index,LVESVI）。结果：与正常对照组相比，慢性心力衰竭患者LVESVI，TF及AngⅡ水平明显升高（P＜0.01），LVEF值明显降低（P＜0.01）。心力衰竭患者TF与AngⅡ呈正相关（r=0.2491， P＜0.01）。常规、中剂量福辛普利组治疗后LVESVI,TF及AngⅡ水平较治疗前均有下降 （P＜0.05或P＜0.01），LVEF较治疗前均明显增高（P＜0.05或P＜0.01），且中剂量组治疗后上述改变更显著（P＜0.01）。结论：心力衰竭患者TF与AngⅡ呈正相关关系；福辛普利具有改善心力衰竭患者心功能、对抗血栓前状态的作用，且随着剂量的增加疗效更显著。

Plasma tissue factor and serum angiotensin Ⅱ and the therapeutic effect of different dosages offosinopril on chronic heart failure

ObjectiveTo determine the relation between plasma tissue factor (TF) and serum angiotensin Ⅱ(AngⅡ) and the effect of different dosages of fosinopril on chronic heart failure(CHF). MethodsThirty healthy controls and 35 CHF patients were recruited to observe AngⅡ,TF, left ventricular ejection fractions(LVEF) and left ventricular end-systolic volume index (LVESVI) at baseline and 10 weeks after the treatment. The 35 patients were randomly assigned into 2 groups: A routine dosage fosinopril group received 10 mg once daily and a middle dosage group received 10 mg twice a day for 10 weeks. ResultsCompared with the healthy controls, AngⅡ,TF,and LVESVI significantly increased （P＜0.01） and LVEF significantly decreased （P＜0.01） in CHF patients. The TF was positively correlated with AngⅡ（r=0.2491, P＜0.01） in the patients. After the 10-week treatment with different dosages of fosinopril, AngⅡ,TF,and LVESVI obviously decreased（P＜0.05 or P＜0.01） and LVEF significantly increased in the 2 groups （P＜0.05 or P＜0.01）. The middle dosage group changed more than the routine dosage group （P＜0.01）.ConclusionTF is positively correlated with AngⅡ in CHF patients. Fosinopril can greatly improve cardiac function and antagonize prethrobotic state,and the therapeutic effect improves with the dosage increase.