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在慢性心力衰竭病人,活动肌肉的血流增加程度减弱,而且对任一特定的运动工作负荷来说氧消耗量也比正常人低。运动时代谢性血管扩张的这种损害不能随短期应用血管紧张素转换素转换酶(ACE)抑制剂而获得恢复。不过,长期应用ACE抑制剂却可使骨骼肌的血流量增加,而且这种增加与全身氧耗的改善密切相关。ACE抑制剂的延迟作用可能与其干扰血管组织的肾素-血管紧张素系统和血管壁的重建有关,另外,在慢性心力衰竭病人的前臂内乙酰胆硷所引起的内皮依赖性血管扩张减弱。
In patients with chronic heart failure, the increase in blood flow to the active muscles is diminished, and oxygen consumption is lower for normal exercise than any other exercise. This impairment of exercise-induced metabolic vasodilation can not be restored with short-term administration of angiotensin converting enzyme (ACE) inhibitors. However, long-term use of ACE inhibitors can increase skeletal muscle blood flow, and this increase is closely related to the improvement of systemic oxygen consumption. The delayed action of ACE inhibitors may be related to the renin-angiotensin system that interferes with vascular tissue and the reconstruction of the vessel wall. In addition, acetylcholine-induced vasodilatation in the forearm of chronic heart failure patients is impaired.