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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

1999年第1期

页码:

5-7

栏目:

论著

出版日期:

1999-01-01

文章信息/Info

Title:

Effects of small-dose prostaglandin E1 on severe congestive heart failure and serum endothelin level

作者:

王全顺¹　盛　斌¹　薛玉生¹　巩维如²

1第四军医大学唐都医院心内科　西安 710038　2解放军总医院心内科

Author(s):

Wang Quanshun1;  Sheng Bin1;  Xue Yusheng1;  Gong Weiru2

1Department of Cardiology, Tangdu Hospital, Xi′an 710038　2Department of Cardiology, General

关键词:

前列腺素E1　心力衰竭;  充血性　血流动力学　内皮素

Keywords:

prostaglandin E1　heart failure;  congestive　hemodynamics　endothelin

分类号:

-

DOI:

-

文献标识码:

-

摘要:

为探讨小剂量前列腺素E1(PGE1) 对重度充血性心力衰竭及内皮素(ET) 水平的影响, 对20例经传统治疗无效的心衰患者小剂量静滴PGE1 1周, 观察治疗前后临床症状、血流动力学及ET变化。结果发现, 临床总有效率为95%。肺动脉压(PAP)、肺毛细血管嵌楔压(PCWP) 比治疗前明显下降(4.93±0.53 对4.00±0.53 kPs, P<0.01; 3. 47±0.53 对2.53±0.40 kPa, P<0.01) , 体循环阻力指数(SVRI) 下降(204.8±21.3 对150.6±1.3 kPa.s.L-1.m-2, P<0.05),心指数(CI)上升(2.2±0.1 对2.8±0.2 L.min-1.m-2, P <0.05)。内皮素明显降低(154.56±4.40对118.13±2.24 ng/L, P <0.01)。提示PGE1可降低ET水平并通过多种机制对心衰产生有益的作用。

Abstract:

The purpose of present study was to explore effects of small-dose prostaglandin E1(PGE1) on clinical symptoms, hemodynamics and serum level of endothelin of congestive heart failure. Twenty patients whose symptoms remained unchanged wich conventional therapy were treated with prostaglandin E1 for seven days. The changes in clinical symptoms, hemodynamics and serum level of ET were observed. In the end of treatment, total clinical effective rate was up to 95%. The pulmonary pressu re (PAP) and pulmonary capillary wedge pressure (PCWP) decreased significantly as compared with those before the treatment (4.93±0.53 vs 4.00±0.53kPa, P<0.01; 3.47±0.53 vs 2.53±0.40 kPa, P<0.01) , systemic vascular resistance index(SVRI) increased (204.8±21.3 vs 150.6±1.3 kPa.s.L-1.m-2, P<0.05). ET decreased obviously (154.56±4.40 vs 118.13±2.24 ng/L ,P<0.01). The results showed that PGE1 could decrease ET levels and play a beneficial role in the treatment of congestive heart failure in combination with multiple mechanisms.

参考文献/References

［1］陈国伟, 郑宗锷, 主编. 现代心脏内科学. 长沙: 湖南科学技术出版社, 1996: 604.

［2］Pacher R, Stanek B, hulsmann M , et al. Prostaglandin E1 infusion compared with prostacyclin infusion in patients with refractory heart failure: effects on hemodynamics and neurohumoral variables. J H eart Lung Transplant, 1997; 16 (8) : 878.

［3］吴振西, 林莲初, 喻　庆, 等. 卡托普利对充血性心力衰竭病人血浆内皮素的影响(摘要). 中华心血管病杂志, 1995; 23 (2) : 100.

［4］杨晓红, 王凤飞, 陶桔华, 等. 心力衰竭时血浆内皮素、一氧化氮及血管紧张素Ⅱ的变化及意义. 中华心血管病杂志, 1994; 22(6) : 433.

［5］Hulsmann M , Stanek B, Frey B, et al. Hemodynamic and neurohumoral effects of long-term prostaglandin E1 infusion in outpatients with severe congestive heart failure. J H eart Lung Tranplant, 1997; 16 (5) : 556.

［6］Umemura K, Watanabe S, Kondok, et al. Inhibitory effect of prostaglandin E1 on intimal thickening following photochenically induced endothelial injury in the rat femoral artery. A therosclerosis, 1997; 130 (122) : 11.

备注/Memo

备注/Memo:

(收稿1998-09-09)

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更新日期/Last Update: 1999-01-01