卡维地洛与厄贝沙坦对急性心肌梗死患者血浆组织因子及其途径抑制物的影响

Effects of carvedilol and irbesartan on tissue factor and tissue factor pathway inhibitor in patients with acute myocardial infarction

目的观察卡维地洛与厄贝沙坦及其合用对急性心肌梗死(AMI)患者血浆组织因子(TF)和组织因子途径抑制物(TFPI)含量及活性的影响。方法将30例AMI患者,在常规治疗的基础上随机分为卡维地洛组(络德20 mg/天,n=10)、厄贝沙坦组(安博维150 mg/天,n=10)及联合用药组(络德20 mg/天+安博维150 mg/天,n=10)。另选择健康成年人10例作为对照组。于治疗前及治疗2周后分别采取空腹静脉血,采用酶联免疫吸附法及发光底物法测定血浆TF及TFPI的含量及活性。结果治疗前后AMI患者血浆TF、TFPI含量及活性均高于正常对照组(P<0.05);治疗2周后卡维地洛组、厄贝沙坦组及联合用药组血浆TF含量及活性较治疗前明显降低(P<0.05),联合用药组较卡维地洛、厄贝沙坦单独用药组血浆TF含量及活性降低(P<0.05);卡维地洛组、厄贝沙坦组及联合用药组血浆TFPI含量及活性较治疗前差异无统计学意义。结论卡维地洛和厄贝沙坦可使AMI患者血浆TF的含量及活性降低,且两药联合应用作用更明显,上述两种药对TFPI的含量及活性无明显影响。

Objective To investigate the changes of content and activity of tissue factor（TF） and tissue factor pathway inhibitor（TFPI） in patients with acute myocardial infarction（AMI） treated by irbesartan,carvedilol alone and their combination.Methods Thirty AMI patients were randomly divided into 3 groups： the carvedilol group（20 mg/d,n=10）,the irbesartan group（20 mg/d,n=10） and the combination of carvedilol-irbesartan group（20 mg/d 150 mg/d respectively,n=10）.Besides,10 healthy adults were as control group.The content and activity of plasma TF and TFPI were tested by using enzyme-linked immunosorbent assay（ELISA） and chemiluminescent substrate immunoassay respectively before and after 2 weeks treatment.Results Compared with the control group,the content and activity of TF and TFPI in the 3 groups significantly increased（P0.05）;the content and activity of TF in the 3 groups were significantly lower after 2 weeks treatment than before（P0.05）.Furthermore,the content and activity of TF in the combination of carvedilol-irbesartan group were significantly lower than theother 2 groups（P 0.05）.There was no difference in the content significantly increased and activity of TFPI after 2 weeks treatment.Conclusion The content and activity of TF can be decreased by treatment of carvedilol combined with irbesartan.Furthermore,the combination of carvedilol and irbesartan could enhance the effects.Neither irbesartan nor carvedilol has significant effect on the content and activity of TFPI.