摘要
目的:比较缬沙坦及贝那普利对慢性充血性心力衰竭(CHF)患者细胞凋亡相关因子的干预作用。方法:随机将CHF组69例患者分为2个亚组:在强心利尿、扩血管、应用β受体阻滞剂等常规治疗基础上加用贝那普利者为血管紧张素转化酶抑制剂(ACEI)亚组(35例),加用缬沙坦者为血管紧张素受体拮抗剂(ARB)治疗亚组(34例);两亚组均连续治疗12周。检测并对比69例CHF患者治疗前后与20例健康者(正常对照组)的肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、高敏C反应蛋白(hs-CRP)、可溶性凋亡因子(sFas)及sFas配体(sFasL)浓度;并检测CHF组治疗前后左室舒张末内径、射血分数、6min步行试验(6MWT)距离等各指标的变化;对比以上各指标在2个亚组之间的差异。结果:①CHF组血浆TNF-α、IL-1β、IL-6、hs-CRP、sFas、sFasL水平明显高于正常对照组(P<0.01),治疗后均有明显下降(P<0.01),ARB亚组治疗后较ACEI亚组治疗后IL-6、sFas下降更显著(P<0.05);②CHF组治疗后心功能分级、6MWT距离等有显著改善(P<0.05),ARB亚组6MWT距离的增加比ACEI亚组治疗后更显著(P<0.05)。结论:缬沙坦和贝那普利可降低CHF患者细胞凋亡相关因子的水平,改善心脏功能。与贝那普利相比,缬沙坦降低sFas、IL-6水平及增加6MWT距离的作用更明显。
Abstract Objective; To compare the effects of the angiotensin receptor blocker （ARB） with that of the angiotensin-converting enzyme inhibitors （ACEI） on apoptosis-related factors in patients with chronic congestive heart failure（CHF）, Method;Sixty-nine patients with CHF underwent treating with cardiotonic, diuretic and β-adrenergic receptor blocker, were randomized into ACEI group（n = 35） which received benazepril 10 mg daily for 12 weeks and ARB group （n=34） received valsartan 80 mg daily for 12 weeks. The levels of tumor nocrosis factor-α （TNF-β）, interleukin （IL）-1β, IL-6, high sensitivity C-reactive protein （hsCRP）, soluble factor associated suicide （sFas） and sFas ligand （sFasL） in 69 patients with CHF and 20 controls were measured. The left ventricular end- diastolic diameter （LVEDD） and ejection fraction （LVEF） were observed using doppler ultrasonography. NYHA classification and 6-rain walk test （6MWT） in patients with CHF were assessed. Result; ①The plasma levels of TNF-α, IL-1β, IL-6, hsCRP, sFas and sFasL in patients with CHF had significantly decreased after treatments （P〈0.01, compared with pretreatments）. Compared with ACEI subgroup, the plasma levels of IL-6 and sFas in ARB subgroup decreased significantly after treatments （P〈0.05）. ②The level of NYHA classification and 6- rain walk distance in patients with CHF improved significantly （P〈0.05）, and the 6MWT distance of patients in ARB subgroup had improved more significantly than those in ACEI group （P〈0.05）. Conclusion; Valsartan and benazepril may decrease the levels of apoptosis-related factors and improve the symptoms in CHF patients. Prior to benazepril, the effects of valsartan on decreasing the plasma levels of IL-6 and sFas and elevating the 6MWT distance were significant.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2007年第10期762-765,共4页
Journal of Clinical Cardiology
