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目的探讨慢性心力衰竭(CHF)患者血清血管紧张素Ⅰ(AⅠ)、血管紧张素Ⅱ(AⅡ)、心钠素(ANF)和醛固酮(ALD)水平,及经螺内酯(安体舒通)干预治疗后的变化及其临床意义。方法放射免疫法测定CHF组120例和40例对照组血清AⅠ、AⅡ、ANF和ALD水平,对其中66例原发性高血压(DH)患者给予螺内酯干预治疗,测定其治疗前后上述血管活性肽变化。结果CHF患者血清AⅠ、AⅡ和ALD显著高于对照组(t=5.487,t=4.179,t=13.89;P均<0.01),ANF显著低于对照组(t=3.128,P>0.01)。Ⅱ、Ⅲ、Ⅳ级心功能组间AⅡ和ALD水平依次显著升高(FAⅡ=7.850,P<0.01;FALD=3.558,P<0.05)。CHF组中,66例经平均88.7(89±24)d的螺内酯干预治疗后平均AⅡ显著升高(t=2.107,P<0.05),AⅠ、ANF和ALD均无显著变化(P均>0.05)。结论CHF患者血清AⅠ、AⅡ和ALD显著升高,ANF显著下降。经螺内酯治疗后,AⅡ显著升高,但AⅠ、ANF和ALD无明显改变。
Objective To investigate the changes of serum levels of AⅠ, AⅡ, ANF and ALD in patients with chronic heart failure (CHF) and the intervention of spironolactone After the change and its clinical significance. Methods Serum AⅠ, AⅡ, ANF and ALD levels were measured by radioimmunoassay in 120 cases of CHF group and 40 cases of control group. Sixty-six patients with essential hypertension (DH) were treated with spironolactone before and after treatment with the above-mentioned vasoactive peptide Variety. Results The serum levels of AⅠ, AⅡ and ALD in CHF patients were significantly higher than those in the control group (t = 5.487, t = 4.179, t = 13.89; P <0.01). The ANF was significantly lower than that in the control group (t = 3.128, P> 0.01). The levels of AⅡ and ALD in the functional groups Ⅱ, Ⅲ and Ⅳ increased significantly (FA Ⅱ = 7.850, P <0.01; FALD = 3.558, P <0.05). In the CHF group, the average AII of 66 patients treated with spironolactone (mean ± SD 88.7 (89 ± 24) d) was significantly higher (t = 2.107, P <0.05) . Conclusion Serum AⅠ, AⅡ and ALD were significantly increased in CHF patients and ANF was significantly decreased. After spironolactone treatment, A Ⅱ was significantly increased, but AⅠ, ANF and ALD no significant change.