倍他乐克对心衰患者血浆去甲肾上腺素和β受体密度变化的临床分析

CLINICAL ANALYSIS ON THE CHANGE OF THE PLASMA NOREPINEPHRINE AND β-ADENOCEPTOR DENSITY IN HEART FAILURE PATIENTS TREATED WITH BETALOC

目的 :探讨 β受体阻滞剂对心衰患者心脏功能的影响及其与去甲肾上腺素 (NE)和 β受体密度 (β -AR)的关系。方法 :检测 47例Ⅰ、Ⅱ级心衰患者的血浆NE浓度、淋巴细胞 β -AR密度和左室射血分数 (LVEF) ,对照组 2 3例用强心利尿扩血管治疗 ,治疗组 2 4例用传统方法加倍他乐克治疗。结果 :治疗组治疗 2周时NE浓度降低 (P <0 .0 5) ,β-AR密度明显升高 (P <0 .0 5) ,而对照组无明显变化。 6周时治疗组NE浓度进一步下降 (P <0 .0 5) ,但 β -AR密度接近治疗前水平 ,而LVEF显著升高 (P <0 .0 5) ;对照组LVEF亦升高 (P <0 .0 5)。治疗组按LVEF升高程度分为LVEF升高≥ 1 5 %者 1 3例 ,<1 5 %者 1 1例 ,二者比较 :治疗 2周时前者NE显著下降 ,而后者无变化。结论

Objective:To study the plasma norepinephrine (NE)?β-Adenoceptor (β-AR) density of lymphocyte and left ventricular ejection fraction(LVEF) in patients with heart failure. Methods:Forty-seven patients with heart failure (Ⅰ or Ⅱ degree),Control group:23 patients used digoxin and vascular-dilating therapy.Treatment group:24 patients used traditional method and betaloc therapy.Results:The plasma NE level was decreased and β AR density was incresed at the second week in treatment group,but there is no change in control group.The plasma NE concentration further decreased,but β-AR density decreased to pre-treatment level and LVEF increased in treatment group at sixth week.The LVEF of control group was increased.According to the increasing degree of LVEF,treatment group was divided into two groups.Group A:13 patients,the LVEF increasing ≥15%,Group B:11 patients,the LVEF increasing< 15%.The plasma NE concentration of the former was decreased significantly at the second week.But that of the latter has no change.Conclusion:The plasma NE decreasing at early stage is a sensitive quota which announces that betaloc treating is effective.