辅酶Ⅰ对缺血性心衰伴肺部感染患者基质金属蛋白酶等的影响  

Effect of coenzymeⅠ on matrix metalloproteinases in patients with ischemic heart failure and pulmonary infection

作　　者：梁逸强[1] 芩倩 温志浩[1] 吴万里[1] 潘朝锌[1] 庞延 黄明剑[1] LIANG Yiqiang;CEN Qian;WEN Zhihao;WU Wanli;PAN Zhaoxin;PANG Yan;HUANG Mingjian(Department of Cardiology,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China;Department of Emergency,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院心血管科,南宁530023 [2]广西中医药大学第一附属医院急诊科,南宁530023

出　　处：《西北药学杂志》2022年第6期105-110,共6页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金项目(编号:81660778)。

摘　　要：目的 评价辅酶Ⅰ对缺血性心力衰竭(IHF)伴肺部感染患者基质金属蛋白酶(MMP)、血管内皮生长因子(VEGF)、巨噬细胞炎性蛋白-2(MIP-2)、白细胞介素-6(IL-6)及心功能的影响。方法 用随机双盲法将94例IHF伴有肺部感染患者分为试验组和对照组,各47例。对照组参照指南给予综合治疗措施。观察组患者在对照组治疗的基础上肌注辅酶Ⅰ5 mg,每日1次,共14 d。治疗前和治疗后行超声心动图检查,测量左室舒张末期内径(LVEDD)、左室后壁厚度(LVPW)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)、左室重构指数(LVRI)和左室质量指数(LVMI)。检测治疗前后N-末端脑钠肽前体(NT-pro BNP)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、降钙素原(PCT)、巨噬细胞炎性蛋白-2(MIP-2)、血管内皮生长因子(VEGF)和IL-6水平。对治疗后各指标进行安全性评价。结果 观察组总有效率为91.5%(43/47),高于对照组的76.6%(36/47),差异有统计学意义(χ~2=6.008,P=0.014)。治疗后,2组患者血清MMP-2、MMP-9、NT-pro BNP、PCT、MIP-2和IL-6水平较治疗前均降低。治疗后,2组患者血清VEGF水平较治疗前升高。且观察组血清MMP-2、MMP-9、NT-pro BNP、PCT、MIP-2和IL-6水平低于对照组(P<0.05),血清VEGF水平高于对照组(P<0.05)。治疗后,2组患者LVEDD、LVPW、LVESD和LVMI低于治疗前,LVEF和LVRI高于治疗前。且观察组LVEDD、LVPW、LVESD和LVMI较对照组低,LVEF和LVRI较对照组高,差异有统计学意义(P<0.05)。结论 在常规治疗IHF伴有肺部感染的基础上,给予注射用辅酶Ⅰ,可通过抑制心肌纤维化、改善血管再生因子、降低炎症细胞因子表达,进而改善心肌重构,有效控制肺部感染。提示注射用辅酶Ⅰ对提高患者心脏功能、减轻临床症状有较好的临床疗效与安全性。Objective To evaluate the effects of coenzyme I on matrix metalloproteinases(MMP), vascular endothelial growth factor(VEGF), macrophage inflammatory protein-2(MIP-2), interleukin-6(IL-6), and cardiac function in patients with ischemic heart failure(IHF) and pulmonary infection.Methods 94 patients with IHF and pulmonary infection were divided into observation group(47 cases)and control group(47 cases)by a random double-blind method.The 2 groups were given comprehensive treatment measures according to the treatment guidelines.Patients in the observation group received 5 mg of Coenzyme Ⅰ for injection intramuscularly on the basis of the treatment in the control group, once a day, for 14 days. The echocardiographic examinations before and after treatment were performed to measure the left ventricular end diastolic diameter(LVEDD), left ventricular posterior wall thickness(LVPW), left ventricular end systolic diameter(LVESD), left ventricular ejection fraction(LVEF), left ventricular remodeling index(LVRI), left ventricular mass index(LVMI), N-terminal brain natriuretic peptide(NT-pro BNP), matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9), procalcitonin(PCT), macrophage inflammatory protein-2(MIP-2), vascular endothelial growth factor(VEGF) and IL-6, and then to evaluate the safety of each index after treatment.Results The total effective rate of the observation group was 91.5%(43/47), which was higher than of the control group 76.6%(36/47). The difference was statistically significant(χ~2=6.008, P=0.014). After treatment, the serum levels of MMP-2, MMP-9, NT-pro BNP, PCT, MIP-2, and IL-6 in the 2 groups were lower than before treatment. After treatment, the serum VEGF levels of the 2 groups were higher than before treatment. The expression levels of serum MMP-2, MMP-9, NT-pro BNP, PCT, MIP-2, and IL-6 in the observation group were lower than those in the control group(P<0.05), and the serum VEGF expression levels were higher than those in the control group(P<0.05). After treatment, the LVEDD, L

关 键 词：辅酶Ⅰ 基质金属蛋白酶(MMP) 缺血性心力衰竭 肺部感染 炎症细胞因子 心肌纤维化 心室重构 

分 类 号：R972[医药卫生—药品]