螺内酯对慢性心力衰竭患者神经内分泌激素的影响

目的探讨螺内酯对慢性心力衰竭患者神经内分泌激素的影响。方法92例慢性心力衰竭患者(心功能Ⅱ~Ⅳ级),随机分为贝那普利组(对照组),贝那普利+螺内酯组(螺内酯组)。测定治疗前、治疗3个月后血浆去甲肾上腺素、肾上腺素、肾素、血管紧张素Ⅱ、醛固酮、内皮素水平的变化。结果两组治疗后血浆去甲肾上腺素、肾上腺素、内皮素水平均有明显下降(P<0.01),肾素、血管紧张素Ⅱ水平无明显变化(P>0.05)。醛固酮水平在对照组无显著变化(P>0.05),螺内酯组有显著下降(P<0.01)。结论血管紧张素转换酶抑制剂只有与螺内酯长期联合治疗才可以显著降低慢性心力衰竭患者的血浆醛固酮水平。

Effects of antisterone on neuroendocrine hormones in patients with chronic heart failure

Objective To explore the effects on neuroendocrines hormone in patients with chronic heart failure(CHF)by antisterone.Methods 92 patients(New York Heart Association class Ⅱ～Ⅳ)were randomly divided into two groups: benazepril group(control group),combining benazepril and antisterone group(antisterone group).The levels of plasma noradrenaline(NE),adrenaline(E),renin(R),angiotensin Ⅱ(Ang Ⅱ),aldosterone(ALD) and endothelin(ET)were observed before and three months after drugs administration.Results The levels of NE,E,ET were significantly decreased in both groups(P<0.01)after drugs were introduced.There were no significant changes in the activity of plasma R,AngⅡin both groups(P>0.05).In antisterone group,the level of ALD was significantly decreased(P<0.01),but no significant change was seen in control group(P>0.05).Conclusion The level of plasma ALD io only significantly decreased by long-term treatment of combining angiotensin-converting enzyme inhibitors and antisterone in patients with CHF.