卡维地洛对慢性心力衰竭患者血清脂联素表达及心功能的影响

目的探讨卡维地洛对慢性心力衰竭（CHF）患者血清脂联素（APN）、有关心衰标志物表达及心功能的影响。方法选择行常规治疗的60例CHF患者为对照组，同期60例加用卡维地洛治疗的CHF患者为实验组，疗程6个月。观察治疗前后患者的心功能分级、超声心动图下左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）和左心室射血分数（LVEF）及酶联免疫法测定的血清APN、氨基末端脑钠肽前体（NT—proBNP）、心肌肌钙蛋白T（cTnT）水平变化。结果心衰患者的血清APN、NT．proBNP、cTnT水平随着NYHA分级增加而明显升高。治疗6个月后，实验组和对照组治疗总有效率分别为91．7％和7313％，差异有统计学意义（P〈O．01）。治疗后两组患者LVEDD、LVESD均缩小．LVEF明显提高。治疗后，两组血清APN、NT．proBNP、cTnT水平均降低（P〈0．05），且实验组以上指标较对照组下降更为显著，差异有统计学意义（P〈0．05）。结论卡维地洛可以显著降低慢性心力衰竭患者的血清APN、NT-proBNP、cTnT水平，明显改善心功能。

The effects of carvedilol on the expression of serum adiponectin and heart function for patients with chronic heart failure

Objective To investigate the effects of carvedilol on the expression of serum adiponectin, biomarkers of heart failure and heart function of patients with chronic heart failure. Methods 60 cases patients with chronic heart failure for conventional anti-heart failure therapy were selected as the control group. 60 patients at the same period with carvedilol treatment on the basis of conventional therapy were set as experimental group. Two groups were given a certain dose of the drugs for 6 months. The New York Heart Association （NYHA）heart function classification, left ventricular end-diastolic diameter （LVEDD）, left ventricular systolic final inner diameter （LVESD） and left ventricular ejection fraction （LVEF） were observed before and after treatment. The levels of Adiponectin （APN）, N-terminal pro brain natriuretic peptide （NT-proBNP） and cardiac troponin T（cTnT） were measured by enzyme-linked immunosorbent assay before and after treatment. Results With the increase class of NYHA heart function, the serum concentration of APN, NT-proBNP, cTnT in heart failure cases increased significantly. After 6 months treatment, the effective rate of the experimental group was 91.7% and that of the control group was 73.3%. Significantly difference was found in two groups（P〈0.01）. After treatment, LVEDD and LVESD of both groups were decreased significantly, and LVEF of both groups were increased significantly. The serum concentration of APN, NT-proBNP and cTnT decreased significantly （P〈0.05）. Conclusion Carvedilol therapy can reduce the level of APN, NT-proBNP and cTnT in patients with chronic heart failure and improve heart function.