摘要
目的 :了解风湿性心脏病和扩张型心肌病心力衰竭 (心衰 )患者纤溶参数的变化 ,并观察血管紧张素转换酶抑制剂和血管紧张素Ⅱ 1型受体拮抗剂对心衰患者纤溶参数的影响。 方法 :测定 2 0例健康者 (正常对照组 )以及 2 9例风湿性心脏病和 3 1例扩张型心肌病心衰患者血浆组织型纤溶酶原激活物 (t PA)活性和纤溶酶原激活物抑制物 1(PAI 1)活性 ,随后 60例心衰患者被随机分为常规治疗组 ,常规治疗+福辛普利 (fosinopril) 10mg每日 1次 (福辛普利组 ) ,常规治疗 +氯沙坦 (losartan) 5 0mg每日 1次 (氯沙坦组 ) ,均为2 0例 ,治疗 14天后复测t PA和PAI 1活性。 结果 :与正常对照组比较 ,风湿性心脏病和扩张型心肌病心衰患者纤溶参数异常 ,t PA活性下降 ,PAI 1活性升高 (P均 <0 0 1)。常规治疗组纤溶参数无显著变化 (P >0 0 5 ) ,福辛普利组和氯沙坦组纤溶参数明显改善 ,表现为t PA活性上升 ,PAI 1活性下降 (P均 <0 0 1) ,二者改善纤溶参数的效果相似 (P >0 0 5 )。 结论 :风湿性心脏病和扩张型心肌病心衰纤溶参数明显异常 ,血管紧张素转换酶抑制剂和血管紧张素Ⅱ 1型受体拮抗剂能改善心衰患者纤溶参数。
Objective:The study was to investigate the changes of the plasma fibrinolytic parameters in patients with chronic heart failure (CHF) from rheumatic heart disease (RHD) or dilated cardiomyopathy (DCM),and to determin whether angiotensin converting enzyme (ACE) inhibitor and angiotensin Ⅱ type 1 receptor (AT1) antagonist have the similar effects on plasma fibrinolytic parameters. Methods:Plasma tissue plasminogen activator (t PA) activity and plasminogen activator inhibitor type 1 (PAI 1) activity were detected in 20 normal controls,29 patients with CHF from RHD and 31 patients with CHF from DCM.Sixty patients with CHF were randomized to receive fosinopril 10*!mg in addition to conventional therapy or losartan 50*!mg in addition to conventional therapy,or only conventional therapy for 14 days.Plasma t PA and PAI 1 activities were detected at baseline and 14 days after treatment. Results:Compared with normal controls,CHF patients with RHD or DCM had decreased t PA activity(p<0 01)and increased PAI 1 activity (p<0 01).Administration of fosinopril or losartan was associated with the increasing of t PA activity (p<0 01) and decreasing of PAI 1 activity (p<0 01).No significant changes were found on conventional therapy (p>0 05).Fosinopril and losartan showed similar effects on the improvement of plasma t PA and PAI 1 activities (p>0 05). Conclusions:Plasma t PA and PAI 1 activities are abnormal in CHF patients with RHD or DCM. The regimen of ACE inhibtor or AT1 antagonist for patients with heart failure is associated with a singnificant improvement of plasma fibrinolytic parameters.
出处
《中国循环杂志》
CSCD
北大核心
2002年第1期38-40,共3页
Chinese Circulation Journal
