卡维地洛对不稳定型心绞痛心肌缺血及TNFα、IL-6和cTnI的影响

Effects of Carvedilol on Myocardial Ischemia and Blood Levels of TNFα、IL-6 and cTnI in Patients with Unstable Angina

目的观察卡维地洛对不稳定型心绞痛(unstable angina UA)心肌缺血及肿瘤坏死因子α(TNFα)、白细胞介素-6(IL-6)和肌钙蛋白Ⅰ(cTnI)的影响。方法采用随机对照临床研究方法,入选的76例 UA 患者随机分为 A 组(常规组)和 B 组(卡维地洛组)。A 组患者予常规治疗,B 组患者在常规治疗基础上加用卡维地洛,治疗12周,比较 A 组、B 组间治疗前后心肌缺血事件;比较治疗前后 A 组、B 组间及与 C 组(对照组)TNFα、IL-6和 cTnI 浓度;观察 A、B 组试验期内急性心血管事件及药物不良反应;并进行统计学分析。结果 A 组、B 组治疗后心肌缺血事件均比治疗前显著下降,B 组比 A 组更显著(P<0.05,P<0.01);A组、B 组 TNFα、IL-6和 cTnI 浓度比 C 组显著升高(P<0.01);A 组治疗后 cTnI 浓度比治疗前下降(P<0.05),B 组治疗后 TNFα、IL-6和 cTnI 浓度比治疗前下降(P<0.05,P<0.01),与 A 组比较有显著差别(P<0.01);A 组、B 组试验期内急性心血管事件发生无显著性差别(P>0.05),A 组、B 组均无明显不良反应。结论卡维地洛能减轻不稳定型心绞痛心肌缺血及加强心肌保护并降低 TNFα、IL-6浓度,耐受良好。

Objective To investigate the effects of earvedilol on myocardial ischemia and blood levels of TNFα,IL-6 and cTnI in pa- tients with unstable angina. Methods 76 patients with unstable angina were randomized divided into group A and B. The patients in group A recived routine treatment and the patients in group B were given carvedilol based on routine treatment. The treatment period was last for 6 months. Myocardial ischemia in group A and B were compared before and after treatment. Blood levels of TNFα,IL-6,cTnI in group A and B were compared before and after treatment and also compared with those in control group. Cardiovascular events and side effects in group A and B on the treatment period were observed. Results Myocardial ischemia in both groups A and B were significantly decreased after treatment and the changes was more significant in group B （ P 〈 O. 05, P 〈 0. 01 ）. Blood levels of TNFα, IL-6, cTnI in groups A and B were increased significantly than those in control group （ P 〈 0. 01 ）. Blood levels of cTnI in groups A and Blood levels of TNFα, IL-6 , cTnI in group B were significantly decreased after treatment（ P 〈0.05, P 〈0. 01 ）and were more significantly compared with those in groups A. There were no statistical difference on cardiovascular events in groups A compared those in groups B. There were no obvious side effects a- mong the treatment period. Conclusion Carvedilol apparently reduce myocardial ischemia and improve myocardial protection and decrease blood levels of TNFα, IL-6 and kept tolenrance well in patients with unstable angina.