卡维地洛对老年慢性心力衰竭患者血清基质金属蛋白酶-9及心功能的影响

目的探讨卡维地洛对老年慢性心力衰竭患者血清基质金属蛋白酶-9(MMP-9)水平及心功能的影响。方法选择老年慢性心力衰竭患者200例,随机分为常规组(n=100)和观察组(n=100)。常规组给予呋塞米、血管紧张素转换酶抑制剂及洋地黄治疗,观察组在常规组基础上给予卡维地洛治疗。同时选择健康体检者50例为健康对照组。治疗前后采用酶联免疫吸附法测定血清MMP-9的水平,并行超声心动图检查左室舒张末内径(LVEDD)、舒张末期容积(LVEDV),计算左室射血分数(LVEF)。结果 2组治疗前血清MMP-9水平、LVEDD、LV-EDV均高于健康对照组,LVEF均低于健康对照组(P<0.05)。与治疗前相比,2组患者治疗后血清MMP-9及LVEDD和LVEDV明显降低,LVEF均明显升高,差异均有统计学意义(P<0.05);观察组血清MMP-9水平及LVEDD和LVEDV较常规组明显降低,LVEF明显升高,差异有统计学意义(P<0.05)。结论卡维地洛可降低血清MMP-9水平,可能是其改善慢性心力衰竭心室重构及心功能的机制之一。

Effects of carvedilol on serum MMP-9 and heart function in elder patients with chronic heart failure

Objective To observe the influence of carvedilol on serum of MMP-9 and heart function in elder patients with chronic heart failure.Methods 200 aging patients with chronic heart failure were randomly divided into routine treatment group(n = 100) and observation group(n = 100).Meanwhile 50 normal people were enrolled as control group.Routine group was treated with furosemide,ACEI and digitalis.Carvedilol were applied in observation group.Serum levels of MMP-9 before and after treatment was measured by enzyme labeled polyclonal antibody sandwich method.Meanwhile,left ventricular enddiastolic diamter(LVEDD),left ventricular end-diastolis volume(LVEDV) and left ventricular ejection fraction(LVEF) were also measured.Results The serum level of MMP-9,LVEDV,LVEDD were higher in routine group and observation group than control group before treatment(P <0.05).After treatment,serum levels of MMP-9 in routine group and observation group were significantly decreased(P <0.05),LVEF were significantly increased(P <0.05);Compared with routine group,serum levels of MMP-9,LVEDD and LVEDV in observation group were significantly decreased(P <0.05),LVEF were significantly increased(P <0.05 ).Conclusion Effect of carredilol on serum levels of MMP-9 was probably one of the mechanisms of which improving heart function and ventricular remodeling.