卡维地洛对不稳定型心绞痛患者内皮素及血管性假血友病因子水平的影响

Effects of carvedilol on circulating levels of endothelin and von Willebrand factor in patients with unstable angina pectoris

目的 :观察卡维地洛对不稳定型心绞痛患者内皮素 (ET)及血管性假血友病因子 (v WF)水平的影响。方法 :正常组 2 0例 ,不稳定型心绞痛患者 4 0例采用完全随机化方法分成对照组 (n=2 1)和治疗组 (n=19) ,在常规抗凝、扩血管治疗基础上 ,对照组予苯那普利 (10 mg/ d× 3d)口服 ,治疗组服卡维地洛 (40 mg/ d× 3d) ,在治疗前后分别用放射免疫法和 ELISA法测定 ET及 v WF值 ,同时记录血压和心率。结果 :对照组和治疗组在治疗前 ET(10 1.8± 2 8.9、110 .6± 4 3.5 ) ng/ L ,v WF(16 2 .6± 5 5 .6、172 .9± 37.8) %较正常组 ET(81.2± 34.0 ) ng/ L、v WF(142 .0±4 9.4 ) %明显增高 (P<0 .0 5 ) ,对照组用药后 ET(10 6 .3± 38.2 ) ng/ L和 v WF(15 5 .4± 5 4 .2 ) %与用药前比较 ,差异无显著性 (P>0 .0 5 ) ,治疗组在用药后 ET(89.2± 4 5 .5 ) ng/ L及 v WF(12 9.2± 4 8.8) %与用药前比较 ,差异有显著性(P<0 .0 5 )。结论 :卡维地洛可显著降低不稳定型心绞痛患者的 ET和 v WF水平。

Objective: To observe the effect of carvedilol on circulating levels of endothelin(ET) and von Willebrand factor(vWF) in patients with unstable angina pectoris (UAP). Methods: Forty patients with UAP were randomly divided into two groups. On the basis of anti-coagulated and vasodilator remedy,patients in control group( n =21) were given benazeptil(10 mg/d) for three days,while patients in therapeutic group(n=19) were administered carvedilol(40 mg/d) for three days. Before and at the end of treatment,ET was measured by RIA and vWF by ELISA in patients with UAP and healthy individuals( n =20), heart rate and blood pressure were also recorded. Results: The levels of circulating ET(101.8±28.9,versus 110.6±43.5)ng/L and vWF(162.6±55.6,versus 172.9 ±37.8)% between control group and carvedilol group were not significantly different before treatment, but both were higher than those in healthy individual ET( 81.2±34.0) ng/L, vWF (142.0±49.4)% ( P <0.05). After the treatment, the levels of ET (106.3±38.2)ng/L and vWF(155.4±54.2)% in control group did not decrease significantly ( P >0.05), while those in carvedilol group ET(89.2±45.5) ng/L, vWF(129.2±48.8)% decreased markedly with the reduction of heart rate and blood pressure( P <0.05). Conclusion:Carvedilol can decrease circulating levels of endothelin and von willebrand factor in patients with UAP markedly.