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作 者:张家明[1] 卢永昕[1] 方云东[1] 袁国会[1]
机构地区:[1]华中科技大学协和医院心内科,湖北武汉430022
出 处:《心血管康复医学杂志》2005年第5期459-461,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine
摘 要:目的:观察卡维地络对充血性心力衰竭(CHF)患者促炎细胞因子浓度的影响。方法:选择66例CHF患者,随机分为常规治疗组和卡维地络治疗组,32例健康体检者为正常对照组。用双抗体夹心ELISA法测定血浆肿瘤坏死因子- α(TNF-α)、白介素-6(IL-6)和IL-1β的浓度,分析其与CHF程度的关系。结果:(1)CHF患者三种细胞因子浓度均明显高于正常对照组(P<0.05或<0.01),CHF、程度越重细胞因子浓度越高(P<0.01);(2)治疗后卡维地络组心功能分级左室收缩末内径较治疗前显著降低(P均<0.05),左室短轴缩短率(LVFS)、每搏量(SV)、左室射血分数(LVEF)较治疗前显著升高(P<0.05-<0.01);常规治疗组仅LVEF、显著升高(P<0.05);治疗后卡维地络组LVEF、LVFS较常规治疗组显著升高(P<0.05);(3)治疗后卡维地络组三种细胞因子浓度显著降低(P<0.01或< 0.05);常规治疗组TNF-α、IL-6降低(P<0.05),而IL-1β水平降低不显著。结论:CHF患者促炎细胞因子浓度升高,可作为判断心衰严重程度的指标。卡维地络能有效抑制促炎细胞因子的产生,改善心功能和心室重构。Objective: To investigate the effects of carvedilol on cytokines levels in patients with congestive heart failure (CHF). Methods:All 66 CHF patients were randomly divided into earvedilol therapeutic group (n=33) or conventional therapeutic group (n=33), and 32 cases of healthy persons were regard as normal controls. The concentration of eytokines including tumor necrosis factor (TNF-α), interleukin (IL-6) and IL-β in plasma was determined. Results : The concentrations of plasma TNF-α, IL-6 and IL-β were significantly higher in CHF patients compared with normal controls. The more severe of CHF was, the more higher levels of these eytokines were (P〈0. 01). After 12 weeks of therapy, the level of NYHA functional classification, left vertrieular end-systolic dimension (LVESd) decreased significantly (P〈0. 01); left ventrieular shortaning fraetin (LVFS), stroke volum and left ventrieular ejection fraction (LVEF) increased significantly (P〈0. 05 or P〈0. 01); the concentration of TNF-α, IL-6 and IL-β decreased significantly (P〈0. 01 or d0. 05) in earvedilol therapeutic group; but only LVEF increased, and the concentration of TNF-α, IL-6 decreased (P〈0. 05 all) in conventional therapeutic group. Conclusion: Levels of eytokines in CHF patients increase, and their levels may be used as indicators of CHF severity. Carvedilol can significantly improve cardiac function and remodeling.
分 类 号:R541.61[医药卫生—心血管疾病]
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