达比加群酯联合阿替洛尔对老年持续性心房颤动患者AngⅡ/Rac1/STAT3通路的影响

Influence of dabigatran etexilate combined atenolol on AngⅡ/Rac1/STAT3 pathway in aged patients with persistent atrial fibrillation

目的:研究达比加群酯联合阿替洛尔对老年持续性心房颤动患者血管紧张素Ⅱ(AngⅡ)/Rac相关的蛋白质(Rac1)/信号转导与转录激活因子3(STAT3)通路的影响。方法:选择在我院就诊的老年持续性心房颤动患者150例,按照抽签法分为达比加群酯组(给予达比加群酯胶囊治疗)和联合治疗组(在达比加群酯组基础上联合阿替洛尔片治疗),各75例。连续治疗6周后,比较两组治疗前后AngⅡ、Rac1、STAT3水平、超声心动图相关指标,炎症因子、凝血因子水平,并观察临床疗效和不良反应发生情况。结果:治疗后,与达比加群酯组比较,联合治疗组AngⅡ[(95.85±11.67)ng/L比(85.27±12.48) ng/L]、Rac1[(31.29±5.69)mol/L比(28.15±8.45) mol/L]、STAT3[(43.97±6.19) ng/L比(38.79±5.87) ng/L]、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)、心率(HR)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)水平均显著降低,左室射血分数(LVEF)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(Fg)水平均显著升高,P均<0.01。联合治疗组总有效率显著高于达比加群酯组(96.00%比85.33%,P=0.025),两组不良反应无显著差异(P=0.644)。结论:达比加群酯联合阿替洛尔可调节老年持续性心房颤动患者AngⅡ/Rac1/STAT3通路,改善心功能和凝血功能,降低炎症反应,效果显著。

Objective:To study influence of dabigatran etexilate(DE) combined atenolol on angiotensin II(AngII)/Rac related protein(Rac1)/signal transducer and activator of transcription 3(STAT3) pathway in aged patients with persistent atrial fibrillation(PAF).Methods:According to lottery method, a total of 150 aged PAF patients treated in our hospital were randomly and equally divided into DE group(received DE capsule) and combined treatment group(received atenolol based on DE group). After continuous six-month treatment, levels of AngⅡ, Rac1, STAT3, inflammatory factors, coagulant factors and echocardiographic indexes before and after treatment, clinical therapeutic effect and incidence of adverse reactions were compared between two groups.Results:After treatment, compared with DE group, there were significant reductions in levels of AngⅡ[(95.85±11.67)ng/L vs.(85.27±12.48) ng/L], Rac1[(31.29±5.69)mol/L vs.(28.15±8.45) mol/L], STAT3[(43.97±6.19) ng/L vs.(38.79±5.87) ng/L], left ventricular end-systolic dimension(LVESd), left ventricular end-diastolic dimension(LVEDd), heart rate(HR), levels of interleukin 6(IL-6), tumor necrosis factor α(TNF-α) and C reactive protein(CRP), and significant rise in LVEF, activated partial thromboplastin time(APTT), thrombin time(TT), prothrombin time(PT) and fibrinogen(Fg) level in combined treatment group, P<0.01 all. Total effective rate of combined treatment group was significantly higher than that of DE group(96.00% vs. 85.33%, P=0.025), there was no significant difference in incidence rate of adverse reactions between two groups, P=0.644.Conclusion: Dabigatran etexilate combined atenolol can regulate AngⅡ/Rac1/STAT3 pathway, improve cardiac function and coagulation function, reduce inflammation with significant therapeutic effect in aged patients with persistent atrial fibrillation.