卡维地洛联合螺内酯对慢性心力衰竭患者心肌重塑的影响及机制

发布时间：2018-04-01 10:19

本文选题：慢性心力衰竭　切入点：心肌重塑　出处：《山东医药》2017年48期

【摘要】：目的探讨卡维地洛联合螺内酯对慢性心力衰竭(CHF)患者心肌重塑的影响及作用机制。方法选取CHF患者71例,随机分为观察组36例、对照组35例。两组均口服卡维地洛,观察组加服螺内酯,两组均连续治疗12周。治疗前及治疗12周结束时分别采用彩色多普勒超声诊断仪测定两组左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室收缩末期内径(LVESD)、二尖瓣口舒张期E峰值与A峰值比值(E/A),采用ELISA法检测血清基质金属蛋白酶9(MMP-9)、血管紧张素Ⅱ(AngⅡ)。结果两组治疗后LVEDD、LVESD均较治疗前降低,LVEF、E/A均较治疗前升高,且观察组上述指标变化更显著,组间及组内比较P均0.05。两组治疗前血清MMP-9、AngⅡ水平比较差异均无统计学意义(P均0.05);治疗后两组血清MMP-9、AngⅡ水平均较治疗前降低,且观察组变化更显著,组间及组内比较P均0.05。结论卡维地洛联合螺内酯可抑制CHF患者心肌重塑,改善心功能;降低血清MMP-9、AngⅡ水平可能是其作用机制。
[Abstract]:Objective to investigate carvedilol United spironolactone on chronic heart failure (CHF) effect and mechanism of myocardial remodeling in patients. Methods 71 cases of CHF patients were randomly divided into observation group of 36 cases, 35 cases in the control group. Two groups were treated with carvedilol, observation group with oral spironolactone, two groups were continued for 12 weeks. Before treatment and at the end of the 12 week treatment respectively by color Doppler ultrasound for determination of left ventricular end diastolic diameter two group (LVEDD), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), diastolic mitral E peak and A peak ratio (E/A), ELISA method was used to detect serum matrix metalloproteinase 9 (MMP-9), angiotensin II (Ang II). The results of the two groups after treatment LVEDD, LVESD decreased, compared with before treatment, LVEF, E/A were higher than that before treatment, and to observe the changes of these indicators were more significant between group and group P were more than two 0.05. before treatment, serum MMP-9, Ang II levels were not statistically significant (P < 0.05); the two groups after treatment of serum MMP-9, decrease the levels of Ang II than before treatment, and the observation group was more significant changes, between group and group P 0.05. conclusion carvedilol United spironolactone can inhibit CHF in patients with cardiac remodeling and improve cardiac function; serum MMP-9 Ang, level II may be its mechanism of action.

【作者单位】：北京航天总医院;
【基金】：首都医科大学基础-临床科研合作基金(14JL-L08)
【分类号】：R541.6

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