喹那普利对缺血性心肌病患者血清胶原含量的影响  

Influence of Quinapil on the level of procollagen in patients with ischemic cardiomyopathy

作　　者：王秀艳[1] 董天崴[1] 王立波[1] 石光跃[2] 

机构地区：[1]佳木斯大学附属第一医院循环内科,黑龙江佳木斯市154002 [2]佳木斯市桦川县医院

出　　处：《心血管康复医学杂志》2010年第3期287-290,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察喹那普利对缺血性心肌病(ICM)胶原合成的影响,探讨阻止ICM心肌纤维化方法。方法:采用放免方法测定12例正常者及46例ICM患者应用喹那普利治疗6周前后心肌纤维化指标:血清Ⅰ型胶原的前胶原氨基末端肽(PⅠNP)和Ⅲ型胶原的前胶原氨基末端肽(PⅢNP)含量,超声心动图测舒张末期左室内径(LVEDd),室间隔厚度(IVST),左室后壁厚度(LVPWT),计算左室重量(LVMW)及左室重量指数(LVMI)。结果:①ICM患者血清PⅠNP、PⅢNP含量较正常组显著增高,并随心功能等级增加而升高(P均<0.01);②喹那普利治疗后PⅠNP[(41.28±5.33)μg/L:(74.22±12.08)μg/L]、PⅢNP[(3.96±0.99)μg/L:(10±1.13)μg/L]含量较治疗前显著下降,Ⅰ/Ⅲ较治疗前显著降低[(10.98±2.51):(12.44±1.90),P均<0.01];③治疗后LVEF[(0.59±0.06)%:(0.37±0.06)%]、二尖瓣血流舒张早期流速(VE)和心房收缩期流速(VA)比值VE/VA较治疗前明显升高[(1.05±1.101):(0.78±0.102),P均<0.01],LVMI较治疗前明显降低[(97.27±14.41)g/m2:(113.07±10.21)g/m2,P<0.01],PⅠNP、PⅢNP与LVMI呈正相关(r=0.561,P<0.01;r=0.316,P<0.05),与VE/VA呈负相关(r=-0.497,P<0.01),与LVEF无明显相关性。结论:喹那普利可以抑制PⅠNP、PⅢNP合成,阻止ICM心肌纤维化,从而减轻左室重量,改善心室舒张功能。Objective： To observer the influence of Quinapil on the level of procollagen in patients with ischemic cardiomyopathy （ICM）. Methods： The 46 ICM patients as the treatment group （took Quinapil in 6 weeks） and 12 health person as normal control group were enrolled. The serum amino-terminal propepitide of type Ⅰ procollagen （P Ⅰ NP）, serum amino--terminal propepitide of type Ⅲ procollagen （PⅢ NP） as myocardial fibrotic indices were meas- ured before and after treatment by radioimmunoassay. LVEDd, IVST, LVPWT, LVMW and LVMI were measured and calculated by color ultrasonic cardiogram. Results： （1） The serum levels of P I NP and P Ⅲ NP significantly increased in ICM patients compared with those of normal control group and which paralleled with the classification of CHF NYHA （P〈0.01） ; （2） The levels of serum P Ⅰ NP [ （41.28±5.33）μg/L vs. （74.22±12.08） μg/L] and P [ⅢNP [ （3.96±0.99）μg/Lvs. （10.001±1. 13） μg/L] decreased obviously, and Ⅰ/Ⅲ [ （10.98±2.51） vs. （12.44 ±1.90）1 decreased too （P〈0.01 all） after Quinapil treatment; （3） After treatment by Quinapih the LVEF [ （0.59 ±0.06） % vs. （0. 37±0. 06）%, P〈0.01]], VE, VA and VE/VA [ （1.05±1.101） vs. （0.78±0.102）, P〈 0.01] significantly increased compared with before treatment. The LVMI decreased [ （97.27±14.41） g/m^2 vs. （113.07±10.21） g/m^2, P〈0.01] than before. The serum concentrations of P Ⅰ NP and PⅢ NP were related positivelywiththeLVEF （r=0.561, P〈0.01; r=0.316, P〈0.05） and negatively with VE/VA （r=- 0.497, P〈 0.01）. Conclusion： Quinapril may significantly inhibit synthesis of the P Ⅰ NP and PⅢ NP, inhibit myocardial fibrosis and reduced the LVMW, improved the diastole function of left ventricular for ICM.

关 键 词：喹那普利 心肌疾病 胶原 

分 类 号：R542.2[医药卫生—心血管疾病]