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目的:探讨卡维地洛治疗前后慢性心力衰竭(CHF)患者血浆血管紧张素II(AngII)和内皮素-1(ET-1)水平的变化。方法:入选106例CHF患者随机分为CHF常规治疗组(常规治疗组,n=53)或卡维地洛治疗组(卡维地洛组,n=53),另入选同期健康体检人群为正常对照组(n=50)。测定CHF患者用药前和用药12周后血浆AngII与ET-1水平的变化,并与正常对照组进行比较。结果:治疗前CHF患者血浆AngII与ET-1水平较正常对照组明显升高(P<0.05),常规治疗组与卡维地洛组血浆AngII与ET-1水平没有差异(P>0.05)。治疗后CHF患者左室射血分数(LVEF)明显改善,血浆AngII与ET-1水平显著下降;与常规治疗组比较,卡维地洛组治疗后LVEF升高更明显,血浆AngII与ET-1水平下降更显著(均P<0.05)。Pearson相关分析显示,LVEF与AngII(r=-0.70,P<0.05)和ET-1(r=-0.66,P<0.05)呈负相关,AngII与ET-1呈正相关(r=0.62,P<0.05)。结论:卡维地洛改善CHF患者左室射血分数可能与降低血浆AngII和ET-1水平有关。
Objective: To investigate the changes of plasma levels of angiotensin II (AngII) and endothelin-1 (ET-1) in patients with chronic heart failure (CHF) before and after carvedilol treatment. Methods: One hundred and sixty-six CHF patients were randomly divided into normal CHF group (n = 53) and carvedilol group (n = 53) Control group (n = 50). The plasma levels of AngII and ET-1 in CHF patients before and after 12 weeks of treatment were measured and compared with those of the normal control group. Results: The levels of plasma AngII and ET-1 in CHF patients before treatment were significantly higher than those in normal controls (P <0.05). There was no difference in plasma levels of AngII and ET-1 between routine treatment and carvedilol (P> 0.05). The left ventricular ejection fraction (LVEF) was significantly improved in CHF patients and the levels of plasma AngII and ET-1 were significantly decreased after treatment. Compared with the conventional treatment group, the LVEF increased more significantly in the carvedilol group and the levels of AngII and ET-1 The level decreased more significantly (all P <0.05). Pearson correlation analysis showed that LVEF was negatively correlated with AngII (r = -0.70, P <0.05) and ET-1 (r = -0.66, 0.05). CONCLUSION: Carvedilol improved left ventricular ejection fraction in CHF patients may be related to the decrease of plasma AngII and ET-1 levels.