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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。
Objective To study the relationship between endothelium dysfunction and chronic heart failure and to explore the effect of different dosages of Radix et Rhizoma Rhei on endothelin (ET) in the treatment of heart failure. Methods 74 cases of patients with chronic heart failure (including NYHA Ⅱ 28 cases, Ⅲ grade 24 cases, Ⅳ grade 22 cases) and 24 normal controls, the determination of basal plasma ET values, heart failure patients were randomly divided into small dose Shuzheng group and The conventional dose group, after 8 weeks of treatment, measure the ET value again. Results The plasma levels of ET gradually increased with the severity of chronic heart failure and positively correlated with BSS (P <0.001) and negatively correlated with LVEF (P <0.001) ) ET in the two groups after treatment of anti-chronic heart failure was significantly lower (P <0.01), and ET in the conventional dose group was significantly lower than that in the lower dose group after treatment (P <0.01). Conclusion Endothelial dysfunction is closely related to the severity of heart failure. High-dose statins can significantly reduce ET and improve heart failure.