【摘要】 目的 :探讨螺内酯对扩张型心肌病心力衰竭患者血浆儿茶酚胺、肾素活性、血管紧张素Ⅱ及醛固酮的影响。方法 :入选 2 0例扩张型心肌病心力衰竭患者 ,随机分入螺内酯组与对照组 ,各 10例 ,用螺内酯治疗前与治疗 1个月后 ,用高效液相色谱方法测定血浆去甲肾上腺素、肾上腺素 ,同时采用均相竞争放射免疫方法检测血浆肾素活性、血管紧张素 Ⅱ与醛固酮。结果 :治疗 1个月后螺内酯组血浆去甲肾上腺素、肾上腺素、肾素活性及醛固酮明显低于治疗前 ,也低于对照组。结论 :螺内酯可明显抑制扩张型心肌病心力衰竭患者的儿茶酚胺水平 ,降低肾素活性及醛固酮 ,这些改变有可能为螺内酯明显改善心力衰竭病人预后的重要机制更多还原

【Abstract】 Objective:To determine the effects of spironolactone on neurohormonal factors,catecholamine,plasma renin activity,angiotensin Ⅱ and aldosterone in patients with cardiac insufficiency secondary to dilated cardiomyopathy.Method:Twenty cases suffering cardiac insufficiency secondary to dilated cardiomyopathy were selected and randomly enrolled into two groups,spironolactone group and control group,10 cases in each group.High\|pressure liquid chromatograph(HPLC)was used to detect plasma norepinephrine and adrenaline,plasma renin activity,angiotensin Ⅱ and aldosterone were also analysed by RIAs.Result:Plasma norepinephrine,adrenaline,plasma renin activity and aldosterone in spironolactone group after 1 month treatment were significantly lower than that of the same group before spironolactone treatment and that of control group after 1 month routine therapy.Conclusion:Spironolactone can signifcantly decrease plasma norepinephrine,adrenaline,plasma renin activity and aldosterone in dilated cardiomyopathy patients,these changes may be important mechanisms of spironolactone which could improve the prognosis of congestive heart failure. [更多还原