不同β-受体阻滞剂对心力衰竭患者β-受体与β_1-受体基因表达干预性研究  

A clinical study of lymphocytic β-adrenoceptor and β_1-adrenoceptor gene expression in patients with heart fuilure treated by different β-adrenoceptor antagonists

作　　者：石理[1] 李军[1] 彭澍[1] 刘俭雄[1] 

机构地区：[1]珠海市人民医院心血管内科,广东省珠海519000

出　　处：《中国基层医药》2006年第1期15-17,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省珠海市科技项目(PC2002155)

摘　　要：目的研究心力衰竭患者外周血淋巴细胞β-受体(β-AR)密度和β1-受体基因(β1-AR mRNA)表达水平的变化规律,探讨不同β-受体阻滞剂对β-AR和β1-AR mRNA表达水平的影响。方法将104例心衰患者随机分为非β-受体阻滞剂治疗组(35例)、美托洛尔治疗组(34例)和卡维地洛治疗组(35例),2个月后复测β-AR和β1-AR mRNA表达水平。结果心衰组β-AR密度和β1-AR mRNA表达水平较正常人明显下降(P<0.01),心功能Ⅳ级患者下降更明显(P<0.01)。冠心病与扩张型心肌病两组之间差异无显著意义(P>0.05)。治疗后,美托洛尔治疗组β-AR密度和β1-AR mRNA表达水平明显高于卡维地洛治疗组和非β-受体阻滞剂治疗组(P<0.01),卡维地洛治疗组与非β-受体阻滞剂治疗组差异无显著意义。结论心衰时外周血淋巴细胞β-AR密度和β1-AR mRNA表达水平下调,下调幅度与心衰严重程度有关,与病因无关。应用美托洛尔能明显上调β-AR密度和β1-AR mRNA表达水平,卡维地洛则无此作用。Objective To study peripheral blood lymphocytic β-adrenoceptor（β-AR） densities and β1-adrenoeeptor gene（β1-AR mRNA） expression levels in patients with heart failure,to investigate the influences of different β-adrenoceptor antagonists in β-AR densities and β-AR mRNA expression levels. Methods 104 cases of patients with heart failure were randomly divided into non-β-adrenoceptor antagonist group（35 cases）, metoprolol group（34 casels） and earvedilol group（35 cases）, we repeatly determined the β-AR densities and β-AR mRNA expression levels after two-month therapy. Results The β-AR densities and β1-AR mRNA expression levels in heart failure group reduced significantly compared to these in normal persons（ P 〈 0.01 ）, and there were further decreases in patients with heart failure（NYHAⅣ ）（P 〈 0.01 ）. There were no differences between coronary heart disease group and dilated cardiomyopathy group（ P 〉 0.05）. After two-month therapy, β-AR densities and β1-AR mRNA expression levels in metoprolol group were significantly higher than those in carvendilol group and non-β-adrenoceptor antagonist group （ P 〈 0.01 ）, there were no differences between the latter two groups（ P 〉 0.05）. Conclusions The peripheral blood lymphocytic β-AR densities and β1-AR mRNA expression level down-regulates in heart failure, which correlate with the severity of heart failure but etiological factors. Metoprolol can up-regulate the β-AR densities and β1-AR mRNA expression level,whereas carvedilol has no such effects.

关 键 词：心力衰竭 充血性 Β-受体阻滞剂 Β-肾上腺素能受体 基因表达 

分 类 号：R541.6[医药卫生—心血管疾病]