摘要
目的观察血管紧张素受体拮抗剂氯沙坦对慢性充血性心力衰竭(CHF)患者血清白细胞介素-18(IL-18)水平的影响,并探讨其临床意义。方法临床选择CHF患者76例,随机分为CHF对照组(39例)和CHF治疗组(37例),并以28例健康成人作为正常对照组。CHF对照组和CHF治疗组均给予地高辛、利尿剂、硝酸甘油等常规治疗6个月,CHF治疗组除常规治疗外还加服氯沙坦片(50 mg/d)连续6个月。所有研究对象均在治疗前后测定心脏左室舒张末内径(LVEDD)、左室射血分数(LVEF)、高敏C-反应蛋白(hs-CRP)和白细胞介素-18水平。结果①CHF对照组和CHF治疗组患者治疗前的LVEDD、LVEF、hs-CRP和IL-18均较正常对照组明显改变(P<0.01),且LVEF与IL-18水平成负相关(r=-0.41,P<0.05)。②CHF对照组和CHF治疗组的患者经过6个月的治疗后,与治疗前对比LVEDD均无明显改变(P>0.05),但是治疗后两组患者的LVEF有明显改善(P<0.05),血清hs-CRP和IL-18水平均有降低(P<0.05)。③CHF对照组比较,治疗6个月后CHF治疗组LVEF的改善更为明显,hs-CRP和IL-18水平的下降更加显著(P<0.05)。结论氯沙坦可以进一步改善CHF患者的心功能,这种作用可能通过降低CHF患者IL-18水平,改善炎症反应来实现。
【Objective】To study the effects of Losartan on serum level of interleukin-18（IL-18） in pa-tients with chronic heart failure（CHF）.【Methods】 76 patients with CHF were divided into CHF control group（n =39） and CHF treatment group（n =37）,and another 28 healthy adults were selected as normal con-trol group.Patients in the CHF control group were given conventional medicine treatment such as Digoxin,Diuretics,Nitrates and so on.Patients in the CHF treatment group were given orally Losartan（50 mg/day） for six months besides conventional medicine treatment.Left ventricular end-diastolic diameter（LVEDD）,left ven-tricular ejection fraction（LVEF）,the level of high sensitivity C-reactive protein（hs-CRP） and IL-18 were e-valuated in all subjects before and after treatment.【Results】Compared to those in the normal control group,LVEDD,LVEF,hs-CRP and IL-18 were significantly different（P 0.05） in the both CHF control group and CHF treatment group before treatment,and LVEF is negative related to level of IL-18（R=-0.41,P 0.05）.Although there was no change for LVEDD（P 0.05） after treatment for six months in the both CHF control group and CHF treatment group,LVEF were improved（P 0.05） and hs-CRP and IL-18 were significantly de-creased（P 0.05）.After treatment for six months,LVEF was higher and hs-CRP and IL-18 were significantly lower（P 0.05） in the CHF treatment group compared to those in the CHF control group.【Conclusion】Losar-tan can improve heart function of patients with CHF by decreasing serum level of IL-18 and alleviating in-flammatory reaction.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2011年第11期1429-1431,共3页
China Journal of Modern Medicine
