心力衰竭患者血浆纤溶活性指标的变化及福辛普利的干预作用

目的:探讨心力衰竭患者血浆纤溶活性指标的变化以及血管紧张素转换酶抑制剂福辛普利干预的影响。方法:58例心力衰竭患者随机分成福辛普利组30例和常规治疗组28例,福辛普利组在常规治疗基础上加用福辛普利10mg/d,入院后当天和治疗后2周采血检测血浆纤溶酶原激活剂抑制物1(PAI1)含量与活性、组织纤溶酶原激活剂(tPA)活性。选择20例健康体检者作为正常对照。结果:与健康体检者比较,心力衰竭患者血浆PAI1含量与活性升高,tPA活性降低(P均<0.01);治疗后2周福辛普利组较常规治疗组血浆PAI1含量与活性明显降低(P均<0.01),tPA活性明显升高(P均<0.01)。结论:心力衰竭时血浆纤溶活性降低,福辛普利治疗可改善其纤溶活性,对降低心力衰竭患者血栓栓塞性疾病的发生可能有重要意义。

Changes of Plasma Fibrinolytic Activity and Effects of Fosinopril in Patients With Congestive Heart Failure

Objective:To investigate the changes of plasma fibrinolytic activity and effects of fosinopril in patients with congestive heart failure(HF) .Methods: Fifty-eight patients with HF were randomized into fosinopril group(n=30) and routine treatment group (n=28). Fosinopril group received fosinopril (10 mg/day) orally in addition to routine treatment.Plasma mass concentration and activity of plasminogen activitor inhibitor type-1(PAI-1), activity of tissue plasminogen activator (t-PA) were measured immediately before and 2 weeks after treatment. Twenty healthy persons were assigned as controls.Results:Compared with the controls, plasma mass concentration and activity of PAI-1 was higher (P<0.01), but the activity of t-PA was lower (P<0.01) in congestive heart failure patients. After 2 weeks of therapy, plasma mass concentration and activity of PAI-1 were significantly decreased, activity of t-PA was significantly increased in the fosinopril group compared with the routine treatment group(P<0.01, respectively).Conclusion: Plasma fibrinolytic activity is decresed in congestive heart failure patients. Angiotensin converting enzyme inhibitors can improve fibrinolytic activity and reduce the risk of thromboembolic events in heart failure patients.