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目的:研究老年充血性心力衰竭患者血浆内皮素及肾素系统活性的变化及其临床意义。方法:采用放射免疫分析法分别测定了受试者(心衰组、对照组及健康组)血浆内皮素(ET)、血管紧张素Ⅱ(AⅡ)和醛固酮(ALD)含量,同时用心脏多普勒超声检查心脏左室射血分数(LVEF%),研究血浆内皮素及肾素系统活性的变化及两者相关性。结果:心衰组AⅡ、ET水平较对照组明显增高(P<0.01);心功能Ⅲ、Ⅳ级组AⅡ、ET水平明显高于对照组(P<0.05);与健康组比较,心衰组和对照组AⅡ、ET、ALD水平均明显增高(P<0.05)。心衰组ET水平与AⅡ水平呈正相关(r=0.754,P<0.01),ET水平与ALD水平亦呈正相关(r=0.352,P<0.05)。结论:老年充血性心力衰竭ET及肾素系统活性增加与心衰的严重程度有关,提示内皮素及肾素系统活性在老年充血性心力衰竭的发病中可能起到重要作用。
Objective: To study the changes of plasma endothelin and renin system activity in elderly patients with congestive heart failure and its clinical significance. Methods: The levels of plasma endothelin (ET), angiotensin Ⅱ (AⅡ) and aldosterone (ALD) were measured by radioimmunoassay in the subjects (heart failure group, control group and healthy group) The left ventricular ejection fraction (LVEF%) was measured by echocardiography to study the changes of plasma endothelin and renin system activity and their relationship. Results: The levels of AⅡ and ET in heart failure group were significantly higher than those in control group (P <0.01); the levels of AⅡ and ET in heart function Ⅲ and Ⅳ group were significantly higher than those in control group (P <0.05); Compared with healthy group, And control group AⅡ, ET, ALD levels were significantly higher (P <0.05). The level of ET in heart failure group was positively correlated with AⅡ level (r = 0.754, P <0.01). ET level was also positively correlated with ALD level (r = 0.352, P <0.05). CONCLUSION: The increase of ET and renin activity in elderly patients with congestive heart failure is related to the severity of heart failure, suggesting that the activity of endothelin and renin may play an important role in the pathogenesis of congestive heart failure.