心力衰竭病人前列腺素E1治疗效果与其受体水平的相关性研究

目的 观察前列腺素E1(PGE1)对心力衰竭病人的治疗效果,同时通过血小板上EP 受体改变,探讨其可能机制.方法 86 例病人被随机分为两组:常规治疗组(A 组)48 例,PGE1 治疗组(B 组)38 例.常规治疗组采用目前常规抗心力衰竭治疗,而治疗组加用了PGE1 20 μg 于5%葡萄糖注射液稀释后泵静注14 d 为1 个疗程.以治疗前后心功能改善作为判断标准,同时用PCR 法测定血小板上EP 受体改变.结果 B 组总有效率为92.11%,显著高于A 组75.00%,差异有统计学意义(χ2=3.86,P<0.05);PGE1 治疗的慢性阻塞性肺病、高血压和冠心病病人疗效比较,差异无统计学意义(χ2=0.50,P＞0.05);B 组治疗后EP2 和EP4 水平显著增高,与治疗前比较,差异有统计学意义(t 分别=7.86、3.92,P 均<0.05).结论 PGE1 对慢性阻塞性肺病、高血压和冠心病所致的心力衰竭有较好的疗效,其机制可能与治疗后EP2 和EP4 受体表达增加有关.

Effect of prostaglandin E1 and its relationship to prostaglandin E1 receptors on platelets in patients with heart failure

Objective To observe the effects of prostaglandin E1 on heart failure treatment, to explore its possible mechanism through changes of EP receptors on platelet. Methods A total of 86 patients were randomly divided into two groups： the conventional treatment group（group A） of 48 cases, and PGE1 treatment group（group B） of 38 cases. Group A used conventional anti-heart failure therapy, while group B had PGE1 20 pLg diluted in 5% GS intravenous pump 14 days for a course of treatment. Heart function was improved after treatment as the criterion. Changes of EP receptor on the platelet were detected by PCR method. Results The total effective rate in group B was significantly higher than that of the group A （92.11% vs. 75.00%; χ2=3.86 ,P〈0.05）. The effective rate did not have significantly difference in heart failure patients caused by COPD, hypertension and coronary heart disease （χ2=0.50,P〉0.05）. EP2 and EP4 levels were significantly increased after treatment in group B （t=7.86,3.92,P〈0.05）. Conclusions PGE1 have good effects on heart failure caused by COPD, hypertension and coronary heart disease, which may be related with EP2 and EP4 receptor expression increased after the treatment.