摘要
目的 :观察卡维地洛对慢性心力衰竭 (心衰 )患者血管内皮功能的影响 ,同时观察卡维地洛对患者细胞因子的影响以及与心功能的相关性。方法 :入选慢性心衰患者 5 0例 ,随机分为常规抗心衰组 ( 2 4例 )和卡维地洛组 ( 2 6例 ) ,后者在常规抗心衰治疗基础上加用卡维地洛。疗程为 12周。正常对照组为健康者 ( 2 6例 )。所有慢性心衰患者治疗前后均测定左心室舒张末期内径 (LVDd)和左心室收缩末期内径 (LVDs)、左心室射血分数、肱动脉反应性充血状态下血管内径和血流量的变化、血一氧化氮、内皮素 1、肿瘤坏死因子α、白细胞介素 6等指标。结果 :2组慢性心衰患者肱动脉反应性充血状态下血管内径扩张程度和血流量增加程度均低于正常对照组 (P <0 0 1) ,血一氧化氮、内皮素 1、肿瘤坏死因子α、白细胞介素 6等指标均高于正常对照组 (P <0 0 1)。治疗 12周后 ,卡维地洛组改善肱动脉内皮依赖性舒张功能优于常规抗心衰组 (P <0 0 1) ,改善LVDd、LVDs和左心室射血分数均优于常规抗心衰组 (P <0 0 1)。同时 ,卡维地洛组内皮素 1、白细胞介素 6等指标的下降也优于常规抗心衰组 (P <0 0 1和P <0 0 5 )。另外 ,5 0例慢性心衰患者治疗前左心室射血分数与肿瘤坏死因子α和白细胞介素 6存在一定的负相关 (r =-
Objective:To investigate the effects of carvedilol on vascular endothelium function and cytokine in patients with chronic heart failure(CHF). Methods:Fifty patients with CHF were divided randomly into CHF treatment group(n=24)or carvedilol treatment group (n=26)for 12-week treatment.In addition,26 sex-and age-matched healthy individuals served as controls.Nitrogen monoxide(NO),endothelin(ET-1),tumor necroses factor-α(TNF-α),interleukin-6(IL-6),echocardiography,change of brachial artery blood tube bore and blood flow(in accordance with Celermajaer's method)were detected before and after 12-week treatment. Results:After 12-week treatment,the changes of endothelium dependent blood tube bore dilatation(D%)and blood flow(Q%)under reactive hyperemia in carvedilol treatment group were(8.76±6.53)% vs(5.75±4.38)% and(202.55±115.78)% vs(138.19± 83.56)% in CHF treatment group(p<0.01).The titers of ET-1,IL-6 in carvedilol group were (66.09±19.36)pg/ml vs(82.56±19.48)pg/ml,(199.41±44.56)pg/ml vs(215.20±43.48)pg/ml in CHF treatment group(p<0.01).The LVEF in carvedilol treatment group was significantly increased compared with CHF treatment group(39±4.5)%vs(34.46±4.9)%(p<0.01).The correlation coefficients of LVEF with TNF-α and IL-6 in 50 patients with CHF were,-0.56(p<0.01)and -0.57(p<0.01),respectively. Conclusion:Carvedilol could ameliorate cardiac function and endothelium function,and reduce cardiac chamber and inverse myocardium remodeling,and decrease cytokine(TNF-α and IL-6).
出处
《中国循环杂志》
CSCD
北大核心
2004年第3期194-197,共4页
Chinese Circulation Journal
