【摘要】 目的研究内皮功能不全与慢性心力衰竭的关系,并探讨不同剂量舒降之在心力衰竭治疗中对内皮素(ET)影响。方法对慢性心力衰竭患者74例(其中NYHAⅡ级28例、Ⅲ级24例、Ⅳ级22例)和24例正常对照者,测定基础血浆ET值,心力衰竭患者随机分成小剂量舒降之组与常规剂量组,治疗8周后,再次测定ET值。结果血浆中ET含量随着慢性心力衰竭的严重程度而逐渐增高,与Boston慢性心力衰竭积分(BSS)呈正相关(P<0.001),与左室射血分数(LVEF)呈负相关(P<0.001);经抗慢性心力衰竭治疗后两组患者ET显著降低(P<0.01),其中常规剂量组治疗后ET较小剂量组明显降低(P<0.01)。结论内皮功能损害与心力衰竭的严重程度密切相关,大剂量的他汀类药物能显著降低ET,更好的改善心力衰竭。更多还原

【Abstract】 Objective To study the correlation of the endothelial dysfunction in patients with chronic heart failure and to explore the effect on the endothelin(ET) and nitric oxide(NO) with various dose simvastatin.Methods Seventy-four patients with heart failure(NYHA Ⅱ 28 patients,NYHA Ⅲ 24 patients,NYHA Ⅳ 22 patients)were randomly divided into low-dose and high-dose perindopril groups.The levels of ET and NO were measured just before and 8 weeks after therapy.24 healthy subjects were selected as control group.Results The levels of ET and NO showed a positive correlation with the severity of heart failure and Boston scoring system(BSS)(P<0.001)and a negative correlation with the left ventricular ejection fraction(LVEF)(P<0.001).The levels of ET and NO were reduced after therapy in both groups(P<0.01).The reduced levels of ET and NO with high-dose group were obviously lower than those of low-dose group(P<0.01).Conclusions The endothelial dysfunction was correlated with the severity of the chronic heart failure.The high-dose statins could obviously reduce the levels of ET and NO.The high-dose group had a better effect on the improvement of the heart failure.更多还原