前列地尔对慢性心力衰竭患者心室重构时血清超敏C反应蛋白和胱抑素C表达的影响

Alprostadil improves ventricular remodeling and decrease the level of high sensitivity reactive protein and cystatin-C in patients with chronic heart failure

目的:观察前列地尔对慢性心力衰竭(CHF)患者超敏C反应蛋白(hs-CRP)和胱抑素C(CysC)表达的影响,探讨其改善心室重构可能的机制。方法:选择CHF患者49例,随机分为常规治疗组24例和前列地尔治疗组25例。常规组给予抗心衰药物治疗,前列地尔组在常规组基础上加用前列地尔注射液10μg/d,共14d。测定2组治疗前后血清hs-CRP和CysC浓度,以及左室射血分数(LVEF)等指标并计算左室质量指数(LVMI)。选择健康体检者20例为对照组。结果:治疗前常规组与前列地尔组各项指标比较,差异均无统计学意义(P>0.05);但与对照组比较,2组血清hs-CRP、CysC表达水平及LVMI显著升高(均P<0.01),LVEF显著降低(P<0.01)。前列地尔组治疗后血清hs-CRP、CysC表达水平及LVMI较常规组治疗后显著降低(P<0.05,P<0.01),而LVEF显著升高(P<0.05)。结论:心衰常规治疗基础上加用前列地尔,可进一步下调心衰患者hs-CRP和CysC表达水平、改善心功能及其心室重构。

Objective：To observe the effects of alprostadil on the levels of high sensitivity reactive protein（hsCRP）and cystatin-C（CysC）in patients with chronic heart failure（CHF）and explore their relationship with improvement of ventricular remodeling.Methods：Forty-nine patients with chronic heart failure were randomly divided into two groups,24 cases in conventional group and 25 cases in alprostadil group.The conventional group was given conventional therapy and the alprostadil group was given additional PGE1 10 μg/day intravenously on the basis of conventional therapy for 14 days.The serum concentration of hs-CRP and CysC,the left ventricular ejection fraction （LVEF）,and calculated left ventricular mass index （LVMI）in two groups were compared before and after treatment.Twenty healthy people were recruited as control group without intervention.Results：There were no differences in these parameters between conventional group and alprostadil group before treatment （P〉0.05）.Compared with control group,the level of hs-CRP/CysC and LVMI were significantly higher,LVEF was significantly lower in two chronic heart failure groups （P〈0.01）.After treatment the levels of hs-CRP/CysC and LVMI in alprostadil group decreased significantly,LVEF was higher in alprostadil group than that in conventional group after treatment （P〈0.05,P〈0.01）.Conclusion：Alprostadil can decrease the level of hs-CRP and CysC and improve heart function and ventricular remodeling on the basis of conventional treatment for heart failure.