氯沙坦对心力衰竭患者血浆内皮素-1及降钙素基因相关肽影响.docVIP

氯沙坦对心力衰竭患者血浆内皮素-1及降钙素基因相关肽影响 　【关键词】 氯沙坦 【摘要】 目的 了解心力衰竭患者血浆内皮素-1（ET-1）、血管紧张素Ⅱ（AngⅡ）和降钙素基因相关肽（CGRP）的变化，并观察氯沙坦对其的影响。方法 测定40例健康者（正常对照组）和90例心力衰竭患者血浆ET-1、AngⅡ和CGRP浓度，随后90例心力衰竭患者被随机分成常规治疗组和氯沙坦组（常规治疗+氯沙坦50mg每日1次），每组45例。治疗14天后复测血浆ET-1、AngⅡ和CGRP浓度，同时应用彩色多普勒超声显像仪测量正常对照组和心力衰竭患者治疗前后的左心室射血分数（LVEF）。结果 与正常对照组相比较，心力衰竭患者血浆ET-1、AngⅡ明显升高（P＜0.01），ET-1和AngⅡ与LVEF呈负相关（r=-0.71，r=-0.62，P＜0.01），ET-1和AngⅡ呈正相关（r=0.69，P＜0.01）。治疗14天后，氯沙坦组血浆ET-1明显下降（P＜0.01），CGRP显著升高（P＜0.01），LVEF得到改善（P＜0.05）。而常规治疗组无明显变化（P＞0.05）。结论 心力衰竭患者血浆ET-1、AngⅡ浓度明显升高，且与LVEF呈负相关，血浆CGRP显著下降。氯沙坦具有降低ET-1，升高CGRP并改善LVEF的作用。 　　【关键词】 心力衰竭；内皮素-1；降钙基因相关肽；血管紧张素Ⅱ；氯沙坦 　　The effect of losartan on plasma endothelin-1 and calcitonin gene-related peptide levels in patients with chronic heart failure 　　【Abstract】 Objective To examine the levels of plasma endothelin-1 (ET-1),angiotensinⅡ (AngⅡ) and calcitonin gene-related peptide (CGRP) levels,and study the effect of losartan on the above parameters in patients with chronic heart failure(CHF).Methods Plasma levels of ET-1,AngⅡ and CGRP were detected in 40 normal controls and 90 patients with CHF.Ninty patients with CHF were randomized into receive losartan 50mg in addition to conventional therapy,or only conventional therapy for 14 days.Plasma ET-1,AngⅡ and CGRP were detected at baseline and 14 days after treatment.Left ventricular ejection fractions (LVEF) were measured before and after 14 days of treatment.Results Compared with normal controls,CHF patients had increased in levels of plasma ET-1 and AngⅡ (P＜0.01),plasma CGRP had decreased (P＜0.01).LVEF was significantly negatively correlated with the levels of ET-1 (r=-0.71，P＜0.01)，and AngⅡ (r=-0.62,P＜0.01),ET-1 positively correlated AngⅡ (r=0.69,P＜0.01).Administration of losartan was associated with the decreasing of the levels of plasma ET-1 and increasing the levels of CGR (P＜0.01).LVEF increastd after 14 days of treatment by losartan (P＜0.05).No significant changes were found on conventional therapy (P＞0.05).Conclusion The levels of plasma