摘要
目的与正常人群比较,观察慢性心力衰竭患者外周静脉血凋亡基因PDCD5血清抗体变化以及卡维地洛治疗的影响。方法采用酶联免疫方法测定慢性心力衰竭患者(n=20,左室射血分数<45%)外周静脉血PDCD5抗体,并与正常人群(n=20)对比,经卡维地洛治疗(70%患者达到目标剂量25mg,2次/d)6个月,复查PDCD5抗体及超声心动图,并观察临床状况的变化。结果慢性心力衰竭患者血清PDCD5抗体A值3.5±1.4显著高于正常对照组1.9±1.0(P<0.01),卡维地洛治疗后该值显著下降至2.5±1.2(P<0.05)。卡维地洛治疗后心功能NYHA分级提高0.3(P<0.05),左室射血分数由35.5%±7.8%增加至42.7%±9.6%(P<0.05),左室舒张末期内径降低5.3mm(P=0.043),左室收缩末期内径降低8.1mm(P<0.01)。结论与正常人群比较,慢性心力衰竭患者血清存在凋亡基因PDCD5抗体,卡维地洛治疗后该抗体滴度下降提示卡维地洛具有抗细胞凋亡作用。
Objective To observe the changes of serum PDCD5 antibody in chronic ischemic heart failure patients and the effect of carvedilol treatment.Methods Twenty chronic ischemic heart failure patients, 11 males and 9 females, aged 58±13, with the left ventricular ejection fraction (LVEF) <45% by echocardiography and New York Heart Association (NYHA) cardiac function classification Ⅱ-Ⅲ, were treated with carvedilol for 6 months with a target dosage of 50 mg/d. The serum PDCD5 antibody was tested by ELISA before and after carvedilol treatment and compared with those of 20 healthy persons.Results The A value of PDCD5 antibody in the heart failure patients was 3.5±1.4 , significantly higher that in than healthy persons (1.9±1.0, P<0.01). After treatment of carvedilol, the A value of PDCD5 antibody in the heart failure patients decreased to 2.5±1.2 (P<0.05). In 6 months maintenance treatment, 14 (70%) patients reached the dosage 50 mg/d, 4 (20%) reached 25 mg/d, and 2(10%) reached 12.5 mg/d. Five patients (25%) had side effect such as dizziness, nausea and cough, one patient (5%) was hospitalized for 3 weeks because of heart failure, no patient died. After treatment of carvedilol, the NYHA degree increased by 0.3 (P<0.05), LVEF increased from 35.5%±7.8% to 42.7%±9.6%(P<0.05), left ventricular end-diastolic diameter decreased 5.3 mm(P<0.05), and left ventricular end-systolic diameter decreased by 8.1 mm (P<0.01).Conclusion The titer of apoptosis gene PDCD5 antibody in the serum of chronic ischemic heart failure patients are higher, which shows apoptosis and treatment of carvedilol significantly decreases its titer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2005年第10期676-678,共3页
National Medical Journal of China
基金
北京大学人类疾病基因研究中心"985计划"基金资助项目