己酮可可碱治疗慢性充血性心力衰竭患者的远期疗效  

Long-term effects of pentoxifylline in patients with congestive heart failure

作　　者：赵培[1] 龚开政[1] 孙红光[1] 吕晓蕾[1] 王顺娣[1] 孙晓宁[1] 杨慧芳[1] 蔡萍[1] 凤以良[1] 张振刚[1] 

机构地区：[1]扬州大学第二临床医学院心血管内科,江苏扬州225001

出　　处：《心脏杂志》2008年第1期51-54,共4页Chinese Heart Journal

基　　金：江苏省卫生厅项目资助(H200356)

摘　　要：目的观察己酮可可碱(PTX)治疗慢性充血性心力衰竭(CHF)患者远期疗效。方法81例CHF患者在常规抗心衰治疗基础上被随机分成PTX组(PTX200mg,每日3次,n=41)和安慰剂组(n=40),共治疗12个月。观察治疗前后血浆细胞因子水平、NYHA心功能分级、心脏结构和功能、生活质量、运动耐量的变化以及PTX治疗对再住院率和病死率的影响。结果74例CHF患者完成随访。与安慰组比较,PTX可显著降低血浆中高敏C反应蛋白、肿瘤坏死因子-α和单核细胞趋化蛋白-1的水平(均P<0.05)。此外,PTX在降低左室舒张末内径[(56±9)mmvs(61±7)mm,P<0.05]、增加左室射血分数[(48±11)%vs(41±12)%,P<0.05]和降低再住院率(34%vs61%,P<0.05)等方面较安慰剂组更显著,但两组间病死率无显著差异。结论在常规抗心衰治疗基础上加用PTX可进一步改善CHF患者的临床状态,降低再住院率。AIM To evaluate the long-term effects of pentoxifylline （PTX） on patients with congestive heart failure （CHF）. METHODS A total of 81 patients with CHF, on the basis of conventional therapy, were randomized to PTX （ PTX 200mg 3 times daily, n = 41 ） group or placebo group （ n = 40） with a 12-month follow-up. The effects of PTX on the plasma levels of the inflammatory mediators, NYHA classification, cardiac structure and function, quality of life and exercise capacity, rehospitalization and mortality were determined. RESULTS The 12-month follow-up was completed in 74 patients. The levels of high sensitivity C reactive protein （hs-CRP）, tumor necrosis factor-α （TNF-α）, interleukin-6 （ IL-6）, monocyte chemoattractant peptide-1 （ MCP-1 ）, soluble intercellular adhesion molecule-1 （ sICAM-1 ） and IL-10 concentrations in CHF patients were significantly higher than those in the healthy control. Compared with those in the placebo group, the levels of hs-CRP, TNF-α, and MCP-1 in PTX group significantly decreased after a 12-month （all P 〈 0.05 ）. PTX treatment decreased left ventricular end-diastolic dimension [ （61±7） mm vs （56 ±9） mm, P 〈0.05]and rehospitalization （P 〈0.05）, and increased left ventricular ejection fraction [ （41 ± 12） % vs （48 ± 11 ） %, P 〈0.05], scores of life quality and 6-minute walking distance （ all P 〈 0.05 ）. But no significant difference in mortality was found between the two groups. CONCLUSION Conventional therapy plus pentoxifylline may further improve the clinical status and reduce rehospitalization in patients with CHF.

关 键 词：己酮可可碱 心力衰竭 充血性 炎症介质 细胞因子 

分 类 号：R972[医药卫生—药品]