1 临床资料 2004-05/2005-11高尿酸血症患者35(男28,女7)例,年龄40±17(35～68)岁,选择尿酸正常者35例作为对照组,年龄35±19(35～65)岁.

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)在我国是常见病,是一种具有气流受限特征的疾病.气流受限不完全可逆,呈进行性发展,与肺部对有害气体或有害颗粒的异常炎症反应有关.慢性气道炎症是COPD主要发病机制,影响COPD发生、发展及转归.

许多研究表明,原发性高血压常伴发左心室肥厚 (LVH),LVH是心血管疾病的独立危险因素,与心功能减退、室性心律失常、猝死密切相关.LVH的逆转可能与预后的改善有关.本研究旨在利用超声心动图检查LVH及质量指数,探讨辛伐他汀长期治疗对原发性高血压患者LVH的影响.

Objective To observe the changes of plasma angiotensin(Ang) and aldosterone(ALD) activity and the extend of aldosterone escape in patients with congestive heart failure after treatment of angiotensin converting enzyme inhibitor(ACEI) and to explore the effective role after adding spironolactone treatment.Methods Ninety-three consecutive patients with congestive heart failure were divided into two groups randomly: group one(observational group),standard treatment with ACEI,together with spironolactone treatment,group two(control group),standard treatment with ACEI without spironolactone.The activities of plasma rennin,angiotensin and aldosterone were measured in the two groups before and 6 months after ACEI treatment by the method of radioimmunoassay test.The activities of Ang and Ald and the degree of aldosterone escape were compared between the two groups.For identification of improvement of heart function,the distance after 6 minutes walk test was compared between the two groups before and after treatment.Results ①After 6 months treatment in spironelatone group the level of ALD was significantly different compared with before the treatment(205±30)(pmol/L) vs(148±60)(pmol/L).After 6 months treatment in control group the level of ALD was increased significantly compared with before the treatment(170±68)(pmol/L) vs(144±63)(pmol/L).②The distance of 6 minuets walk test bacame much longer in spironelatone group after 6 months treatment before [(420±163) m vs(338±118) m].There was significant improvement in walk efficiency in control group after 6 months treatment comparing with that before treatment [(380±120) m vs(346±106) m].Conclusion ①The aldosterone escape appears in congestive heart failure patients with ACEI treatment irrespective of spironolactone use.In terms of aldosterone escape,the effect of spironolactone treatment group seems more apparent comparing with the control group.The spironolactone,analdosterone receptor antagonist,may combine to the receptor and increase concentration of free aldosterone in plasma.②Patients treated with spironlactone have good movement endurance of 6 minutes walking after 6 months treatment.It indicates that spironolactone contribute to improve the prognosis of patients with congestive heart failure by improving heart function and it may prevent ALD from the gene expression of collagen Ⅰ,Ⅲ,and ALD can promote cardiocyte fibrosis by increasing collagen.