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目的观察卡维地洛对慢性心力衰竭(心衰)患者神经激素及镁代谢的影响。方法57例心衰患者随机分为2组,分别在常规治疗基础上合用卡维地洛或谷维素治疗8周,治疗前后测定血浆去甲肾上腺素、肾素(PRA)、血管紧张素-Ⅱ(ANG-Ⅱ)、醛固酮(ALD)、血浆镁浓度(PMC)、外周血单核细胞镁含量(MMC)及24H尿镁排泄量(UME),并选择26例健康者为正常对照。结果与正常对照组比较,心衰患者血浆去甲肾上腺素、PRA、ANG-Ⅱ、ALD及尿UME均明显升高,MMC降低(P<0·01),UME分别与ALD、ANG-Ⅱ、PRA呈正相关(R=0·41、0·42、0·38,P<0·01)。卡维地洛治疗后,血浆ALD、PRA、ANG-Ⅱ及尿UME降低(P<0·05),MMC增加(P<0·01)。结论卡维地洛阻断神经激素激活,同时减少尿镁排泄,增加细胞内镁水平。
Objective To observe the effects of carvedilol on neurohormones and magnesium metabolism in patients with chronic heart failure (CHF). Methods Fifty-seven patients with heart failure were randomly divided into two groups. The patients were treated with carvedilol or oryzanol for 8 weeks on the basis of routine treatment. Plasma norepinephrine, renin (PRA) and angiotensin-Ⅱ ALD, PMC, MMC and 24H urinary magnesium excretion (UME), and 26 normal controls were selected as healthy controls. Results Compared with the normal control group, plasma norepinephrine, PRA, ANG-II, ALD and urinary UME in patients with heart failure were significantly increased, MMC decreased (P <0.01) PRA was positively correlated (R = 0.41, 0.42, 0.38, P <0.01). After carvedilol treatment, plasma ALD, PRA, ANG-II and urine UME decreased (P <0.05) and MMC increased (P <0.01). Conclusion Carvedilol can block the activation of neurohormones, reduce the excretion of urinary magnesium and increase the level of intracellular magnesium.