文本框: THE EFFECT OF ORAL ENALAPRIL ON HEMODYNAMICS AND NEUROHORMONE IN CHILDREN WITH LEFT-TO-RIGHT SHUNT Wang XQ, Zhou TF, Jin ZH, Hua YM The Second Hospital of West-China University of Medical Sciences, ChengDu, China Objective: To explore the indication of enalapril, an agent of angiotensin-converting enzyme inhibitors, in the treatment of children with left-to-right shunt. Method: We examined the index of hemodynamics plasma rennin activity (PRA) angiotensinⅡ(AngⅡ) norepinephrine(NE) from 36 children who were devided into four groups according to the QP/QS and Right Ventricular Projection Period (RPEP)/Velocity Time Integral (VTI) (groupⅠQP/QS<2.0 RPEP/VTI≤0.4; groupⅡQP/QS≥2.0 RPEP/VTI≤0.4; groupⅢQP/QS≥2.0 RPEP/VTI≤0.4 with overt CHF; groupⅣRPEP/VTI≥0.6). At the same time before and after oral enalapril at 0.8mg/kg.d. Results: ①In groupⅢQP, QP/QS, QL→R and ESWS decreased significantly, meanwhile ejection fraction(EF) increased after enalapril; ②In groupⅣ enalapril caused a significant increase in QP and QL→R among the most of cases; ③each parameters had no significant changes in groupⅠand group Ⅱ. Conclusion: Our study indicates that enalapril may benefit case with left-to-right shunt and CHF whose PVR is normal but PRA is elevated; the use of enalapril in children with left-to-right shunt and markedly elevated PVR should be prudent. The effect of oral enalapril on hemodynamics and neurohormone in children with left-to-right shunt 0691