不同血压心力衰竭患者肾素-血管紧张素-醛固酮系统的活性

目的为探讨不同血压的充血性心力衰竭(CHF)患者肾素-血管紧张素-醛固酮系统(RAAS)的活性。方法运用放免法测定收缩压(SBP)<100mmHg(1mmHg=0．133kPa)的CHF患者(LPCHF组，22例)，SBP>100mmHg的CHF患者(HPCHF组，25例)及健康人(对照组，18例)血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)及醛固酮(ALD)水平。结果LPCHF组及HPCHF组血浆PRA、AngⅡ和ALD均明显高于对照组(P<0．05～0．01)，LPCHF组血清钠、SBP及脉压SBP显著低于对照组(P<0．05～0．01)；LPCHF组血浆PRA、AngⅡ和ALD高于HPCHF组(P<0．05～0．01)，LPCHF组血清钠、SBP及脉压SBP显著低于HPCHF组(P<0．05～0．01)；CHF患者脉压SBP与血浆AngⅡ及ALD呈显著负相关(r=－0．501，P<0．01，r=－0．439，P<0．01)。结论CHF患者体内RAAS活性增高，且SBP<100mmHg者较SBP>100mmHg更高。

The renin-angiotensin-aidosterone activity in patients with heart failure of different blood pressure

Objective:To explore the renin-angiotensin-aldosterone sytem activity(RAAS) of patients with congestive heart failure (CHF) in relation with their blood pressure. Method:47 patients were divided into two groups according to their systolic blood pressure (SBP) :(①)patients with SBP＜l00 mmHg(LPCHF, n = 22);② patients with SBP＞ 100 mmHg (HPCHF, n = 25). Normal control group included 18 health people. Plasmal levels of renin,angiotensin and aldosterone activity (PRA,Ang Ⅱ and ALD) were measured by radio-immunity assay (RIA). Result:Plasma levels of PRA,Ang Ⅱ and ALD in LPCHF and HPCHF groups were significantly higher than those in control group ( P ＜ 0. 05 ～ 0. 01), especially in LPCHF group (compared with HPCHF group, P ＜0.05 ～ 0.01). LPCHF group had lower serum sodium, SBP and pulse pressure/systolic pressure compared with HPCHF group ( P ＜0. 05～0.01). There was a negative correlation between the pulse pressure/ systolic pressure and the Ang Ⅱ and ALD levels(r =-0.501, P ＜0.01/r =-0.439, P ＜0.01) in CHF patients. Conclusion:RAAS activity is increased in the CHF patients,especially in the patients with SBP lower than 100 mmHg.