[1]李莹,宋耀明,黄岚,等.培哚普利与坎地沙坦对慢性心力衰竭患者ET-1、IL-6、MMP-9及左心室重塑的影响[J].陆军军医大学学报(原第三军医大学学报),2011,33(06):633-636.
 Li Ying,Song Yaoming,Huang Lan,et al.Effects of perindopril and candesartan on left ventricular remodeling and serum ET-1, IL-6 and MMP-9 levels in patients with chronic heart failure[J].J Amry Med Univ (J Third Mil Med Univ),2011,33(06):633-636.
点击复制

培哚普利与坎地沙坦对慢性心力衰竭患者ET-1、IL-6、MMP-9及左心室重塑的影响(/HTML )
分享到:

陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
33卷
期数:
2011年第06期
页码:
633-636
栏目:
论著
出版日期:
2011-03-30

文章信息/Info

Title:
Effects of perindopril and candesartan on left ventricular remodeling and serum ET-1, IL-6 and MMP-9 levels in patients with chronic heart failure
作者:
李莹宋耀明黄岚耿召华任可赵友光李佳
第三军医大学新桥医院:心血管内科,全军心血管病研究所, 急诊科;成都军区总医院泌尿外科
Author(s):
Li Ying Song Yaoming Huang Lan Geng Zhaohua Ren Ke Zhao Youguang Li Jia
Department of Cardiovascular Diseases, Department of Emergency, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037; Department of Urology, General Hospital of Chengdu Military Command, Chengdu, Sichuan Province, 610083, China
关键词:
培哚普利坎地沙坦心力衰竭 内皮素-1基质金属蛋白酶-9左心室重塑
Keywords:
candesartan perindopril chronic heart failure endothelin-1 interleukin-6 MMP-9 left ventricular remodeling
分类号:
R541.6;R972.2;R972.4
文献标志码:
A
摘要:
目的    探讨慢性心力衰竭(chronic heart failure,CHF)患者应用培哚普利和(或)坎地沙坦治疗对血浆内皮素-1(ET-1)、白介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)干预以及改善心室重构作用。    方法    90例CHF患者在常规治疗基础上采取双盲随机分为3组,每组30例。A组:培哚普利组 4 mg/d;B组:坎地沙坦 4~8 mg/d;C组:培哚普利4 mg+坎地沙坦4~8 mg/d。疗程均为8周。26例健康体检者为正常对照组。分别测定治疗前、后患者血清ET-1、IL-6、MMP-9的浓度。采用心脏彩色多普勒测定左心室射血分数(LVEF)、左心室舒张末内径(LVEDd)。    结果    CHF患者ET-1、IL-6、MMP-9显著高于正常对照组(P<0.01);CHF患者ET-1、IL-6、MMP-9与LVEDd呈正相关(r=0.436, P<0.01),与LVEF呈负相关(r=-0.481, P<0.01)。经过8周治疗后,3组血清ET-1、IL-6、MMP-9及LVEDd均较治疗前明显减小,LVEF均较治疗前升高(P<0.05)。C组经治疗后血清ET-1、IL-6、MMP-9水平及LVEDd与A、B组比较明显减小,LVEF明显增高(P<0.05);而A、B组差异无统计学意义( P>0.05)。    结论    CHF患者血清ET-1、IL-6、MMP-9、LVEDd水平显著升高,LVEF显著降低,且与心衰严重程度相关。培哚普利与坎地沙坦均能降低ET-1、IL-6、MMP-9水平,且疗效两者联合治疗明显优于单用培哚普利或坎地沙坦治疗。
Abstract:
Objective    To evaluate the effects of perindopril and/or candesartan on the levels of endothelin-1 (ET-1), interleukin-6 (IL-6) and matrix metal proteinase-9 (MMP-9) in serum and the left ventricular remodeling in patients with chronic heart failure (CHF).     Methods    Serum concentrations of ET-1, IL-6 and MMP-9 in normal controls (n=26) and patients with CHF (n=90), who were randomized into perindopril group (4 mg/d of perindopril), candesartan group (4 to 8 mg/d of candesartan) and combined group (4 mg/d of perindopril and 4 to 8 mg/d of candesartan) were measured before and after 8-week treatment. Left ventricular end-diastolic dimension (LVEDd) and left ventricular ejection fraction (LVEF) were measured by color Doppler echocardiography before and after the treatment.     Results    Before treatment, serum ET-1, IL-6 and MMP-9 levels in patients were significantly higher than those in normal subjects (110.31±18.83 vs 48.16±8.21, P<0.01; 116.39±16.52 vs  62.47±10.78, P<0.01; 248.31±65.42 vs 74.63±9.87, P<0.01; respectively). Serum ET-1, IL-6 and MMP-9 levels were positively correlated with LVEDd (r=0.436, P<0.01), and negatively correlated with LVEF (r=-0.481, P<0.01). After treatment, serum ET-1, IL-6 and MMP-9 levels and LVEDd in the combined group were significantly lower than those in the perindopril group and the candesartan group (63.52±17.17 ng/ml vs 79.24±12.81 ng/ml vs 75.47±16.23 ng/ml, P<0.05; 82.58±9.47 ng/L vs 94.16±11.43 ng/L vs 91.46±10.27 ng/L, P<0.05; 183.52±30.66 pg/ml vs 208.16±36.62 pg/ml vs 205.91±32.28 pg/ml, P<0.05; 50.51±6.38 vs 55.73±7.85 vs 55.16±8.19, P<0.05; respectively). On the contrary, LVEF in the combined group was significantly higher than that in the perindopril group and the candesartan group (49.21±8.59 vs 44.87±4.73 vs 46.17±6.36, P<0.05). However, no such difference was noted between the perindopril group and the candesartan group (P>0.05).     Conclusion    Perindopril combined with candesartan is remarkably superior to perindopril or candesartan alone in treating patients with CHF. The combined therapy can effectively decrease serum ET-1, IL-6 and MMP-9 levels and LVEDd while increasing LVEF.

相似文献/References:

[1]刘超,宋耀明,黄岚,等.缬沙坦与培哚普利对扩心病心力衰竭患者细胞因子和心肌纤维化的影响[J].陆军军医大学学报(原第三军医大学学报),2008,30(12):1189.
 LIU Chao,SONG Yao-ming,HUANG Lan,et al.Effects of valsartan and perindopril on serum cytokine levels and myocardial fibrosis in patients with chronic heart failure resulting from dilated cardiomyopathy[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(06):1189.
[2]耿召华,李隆贵,黄坚,等.培哚普利对慢性心功能不全大鼠心肌肌浆网Ca2+泵功能的影响[J].陆军军医大学学报(原第三军医大学学报),2000,22(09):0.[doi:10.16016/j.1000-5404.2000.09.023 ]
 GENG Zhao hua,LI Long gui,HUANG Jian,et al.[J].J Amry Med Univ (J Third Mil Med Univ),2000,22(06):0.[doi:10.16016/j.1000-5404.2000.09.023 ]
[3]耿召华,李隆贵,黄坚,等.培哚普利对心衰大鼠心肌肌浆网Ca2+泵活性和Ca2+释放通道密度的影响[J].陆军军医大学学报(原第三军医大学学报),2000,22(12):0.[doi:10.16016/j.1000-5404.2000.12.009 ]
[4]冯正平,张忠辉,张平,等.培哚普利对糖尿病肾病肾脏前列腺素代谢的影响[J].陆军军医大学学报(原第三军医大学学报),1999,21(04):0.[doi:10.16016/j.1000-5404.1999.04.024 ]
 Feng Zhengping,Zhang Zhonghui,Zhang Ping,et al.[J].J Amry Med Univ (J Third Mil Med Univ),1999,21(06):0.[doi:10.16016/j.1000-5404.1999.04.024 ]
[5]冯正平,张忠辉,张平,等.培哚普利对糖尿病肾病内皮细胞功能的影响[J].陆军军医大学学报(原第三军医大学学报),1998,20(05):0.[doi:10.16016/j.1000-5404.1998.05.029 ]
 Feng Zhengping,Zhang Zhonghui,Zhang Ping,et al.[J].J Amry Med Univ (J Third Mil Med Univ),1998,20(06):0.[doi:10.16016/j.1000-5404.1998.05.029 ]
[6]陈光辉,祝善俊,袁玉权,等.培哚普利治疗充血性心衰的临床研究[J].陆军军医大学学报(原第三军医大学学报),1997,19(03):0.[doi:10.16016/j.1000-5404.1997.03.027 ]
 Chen Guanghui,Zhu Shanjun,Yuan Yuquan.[J].J Amry Med Univ (J Third Mil Med Univ),1997,19(06):0.[doi:10.16016/j.1000-5404.1997.03.027 ]
[7]冯正平,张忠辉,张平,等.培哚普利对糖尿病肾病患者白蛋白、转铁蛋白及尿内皮素1含量的影响[J].陆军军医大学学报(原第三军医大学学报),2001,23(01):0.[doi:10.16016/j.1000-5404.2001.01.037 ]
 FENG Zheng ping,ZHANG Zhong hui,ZHANG Ping,et al.[J].J Amry Med Univ (J Third Mil Med Univ),2001,23(06):0.[doi:10.16016/j.1000-5404.2001.01.037 ]

更新日期/Last Update: 2011-03-15