缬沙坦对急性心肌梗死患者细胞因子和肾素血管紧张素系统的作用研究

Effect of valsartan on cytokine and RAS in patients with acute myocardial infarction

目的:通过研究缬沙坦对急性心肌梗死(AMI)患者的细胞因子、肾素血管紧张素系统(RAS)和心脏功能影响,探讨干预心室重塑的免疫调节机制。方法:已确诊AMI患者被随机分为2组:缬沙坦组(40例)和对照组(39例)。血管紧张素Ⅱ(AngⅡ)和醛固酮及肾素活性(PRA)采用放射免疫法检测。血清细胞因子检测采用双抗体夹心ELISA法,并用超声检测同期心脏功能。结果:与对照组比较,缬沙坦组治疗7d后高敏C反应蛋白、肿瘤坏死因子-α、转化生长因子β1明显下降,白细胞介素-10上升;血浆PRA和醛固酮减少和AngII上升;左室射血分数提高,差异均有统计学意义(P<0.05)。结论:缬沙坦调节AMI患者的细胞因子和RAS,改善心脏功能,具有免疫调节和防治心室重塑的作用。

Objective.. To study the effects of valsartan on the cytokines, RAS, and cardiac function in patients with AMI; and therefore, provide a new theory for the immunoregulation mechanism of valsartan in patient with AMI. Method.. Patients with AMI were randomly divided into valsartan group（40 cases） and control group（39 cases）. AngⅡ , aldosterone, and PRA were detected by radioimmunity. Serum cytokines were detected by ELISA and cardiac function was measured by echocardiography. Result： Compared with control group, the concentrations of hsCRP, TNF-α, TGF-β1 decreased and IL-10 increased; PRA, aldosterone, AngⅡ, and LVEF increased significantly after 7 days treatment in valsartan group （P〈0.05）. Conclusion.. Valsartan regulates cytokines expression and RAS, and improves heart function, suggesting that it has immunomodulation and protection effectron on ventricular remodeling in patients with AMI.