摘要
目的探讨卡维地洛对慢性心力衰竭(心衰)患者心肌重构和血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的影响。方法72例心衰患者随机分为治疗组和对照组各36例。对照组给予洋地黄、利尿剂及血管紧张素转换酶抑制剂。治疗组在此基础上加用卡维地洛。随访半年,治疗前后采用超声心动图、胸部X线和化学发光法测定心功能、心胸比率和血浆TNF-α、IL-1β和IL-6的变化。结果两组治疗后心功能改善,总有效率为77.8%和50%,P<0.01;心胸比率分别为(0.55±0.07和0.58±0.06,P<0.05)。治疗组治疗后左室舒张期末内径和左室收缩期末内径分别为(58.7±6.9)mm和(44.7±7.2)mm,显著低于对照组(61.3±2.7)mm和(50.9±9.2)mm;左室射血分数为(46.3±9.7)%,显著高于对照组(39.9±6.8)%,P<0.01;血浆TNF-α、IL-1β和IL-6分别为(46.08±13.27)pg/ml、(31.32±4.06)pg/ml和(30.26±10.59)pg/ml,显著低于对照组(59.23±18.65)pg/ml、(39.58±11.38)pg/ml和(54.96±20.21)pg/ml,P<0.01)。副作用发生率,两组相比较差异无统计学意义。结论慢性心力衰竭在常规治疗基础上加用卡维地洛安全有效,可以改善心功能,逆转心肌重构,降低血浆主要细胞因子水平。
Objective To evaluate the effect of carvedilol on ventricles remould and TNF,IL-1β,IL-6 in patients with CHF.nethods 72 patients with CHF were divided randomly into treatment guoup and control guoup. One guoup has 36 patients. The patients in control group were treated with digoxin, cliuretic and ACE inhibitor. Another was treated with carvedilol on the basis of above control group. All the patients were folloued up for six months and measures the changes of cardiac function, mind ratio and INF, IL-1β, IL-6 by echecardiography, chest X line,and immunofluorescence techni respectively. Results Treatment group and control guoup after treatment improued cardiac function 77.8% vs 50% P〈0.01, mind ratio （0.55±0.07 vs 0.58±0.06,P〈0.05）. After carvedilol treatment. LVEDD and LVESD （58.7±6.9）mm and （44.7±7.2）mm, were smaller than that in control group（61.3±2.7）mm and （50.9±9.2）mm,LVEF （46.3±9.7）% was higher than that （39.9±6.8）% in control grou （P〈0.01）, TNF （46.08±13.27） pg/ml, IL-1β（31.32±4.06） pg/ml,IL-6（30.26±10.59） pg/ml were lower than those （59.23±18.65） pg/ml, （39.58±11.38） pg/ml, （54.96±20.21）pg/ml, P〈0.01 in control group. The was no difference on side effect in two groups. Conclusion Carvedilol was treated on the basis of above regular treatment has shown more effective and safety on improving cardiac function, ventricles remould and decreasing the inflammation factors with CHF.
出处
《中国心血管病研究》
CAS
2007年第7期530-532,共3页
Chinese Journal of Cardiovascular Research
