目的:分析真武汤联合曲美他嗪对慢性心力衰竭(CHF)患者血清氨基末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)水平和血流动力学的影响。方法:以2022年1月~2023年2月我院中医科收治的CHF患者84...目的:分析真武汤联合曲美他嗪对慢性心力衰竭(CHF)患者血清氨基末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)水平和血流动力学的影响。方法:以2022年1月~2023年2月我院中医科收治的CHF患者84例为研究对象,采用随机数字表法分为对照组和观察组,各42例。对照组采用曲美他嗪进行治疗,观察组在对照组的基础上联合真武汤进行治疗,两组均治疗28d。比较两组治疗后疗效,治疗前和治疗28d后血清NT-proBNP、MMP-9、TIMP-1水平、心功能和血流动力学。结果:治疗28d后,观察组治疗总有效率为95.24%,显著高于对照组76.19%( P <0.05)。治疗28d后,两组血清NT-proBNP、MMP-9水平和左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、心率(HR)、外周血管阻力指数(PVRI)显著低于治疗前,且观察组显著低于对照组( P <0.05);而两组血清TIMP-1水平和左心室射血分数(LVEF)、心输出量(CO)、心脏指数(CI)、每搏输出量指数(SVI)显著高于治疗前,观察组显著高于对照组( P <0.05)。结论:真武汤联合曲美他嗪治疗CHF能显著降低患者血清NT-proBNP、MMP-9水平,升高血清TIMP-1水平,有效抑制患者心肌重塑,改善心功能和血流动力学,具有良好的治疗效果。展开更多
Aims: Metalloproteinases are proteolytic enzymes, which decompose the extracellular matrix, influence cardiac remodelling, and are inhibited by tissue inhibitor of metalloproteinases(TIMPs). Little is known about the ...Aims: Metalloproteinases are proteolytic enzymes, which decompose the extracellular matrix, influence cardiac remodelling, and are inhibited by tissue inhibitor of metalloproteinases(TIMPs). Little is known about the prognostic impact of the TIMP-1/matrix metalloproteinase complex in patients with future cardiovascular death. Methods and results: In 1979 patients with suspected coronary artery disease(CAD), TIMP-1 has been determined at baseline. Among 1945(98.4% ) patients with a mean follow-up period of 2.6± 1.2 years, 75 patients died because of cardiovascular causes. Mean concentrations of TIMP-1 were higher among patients who experienced a fatal cardiovascular event than among those who did not(820 vs. 692 ng/mL; P < 0.001). Age and sex adjusted hazard ratio of future cardiovascular death associated with one standard deviation of TIMP-1 level, was 1.37(95% CI: 1.17- 1.61; P < 0.001). The hazard ratio remained nearly identical after adjustment for clinical and therapeutic confounders. B-type natriuretic peptide(2.75, 95% CI: 1.94- 3.89; P < 0.001), C-reactive protein(1.79, 95% CI: 1.43- 2.24; P < 0.001), and TIMP-1(1.30, 95% CI: 1.07- 1.58; P=0.008) were independently associated with future cardiovascular death. Conclusion: In patients with CAD, TIMP-1 proves as an independent predictor for future cardiovascular death.展开更多
基金This work is supported by the National Natu-ral Science Foundation of China( 3 9970 761) and Major Direction ofChinese Academy of Sciences( KSCX2 -2 -0 4)
文摘目的 :构建特异性切割人组织金属蛋白酶抑制剂 1 (tissue inhibitor of m etalloproteinases1 ,TIMP- 1 )的锤头状核酶的真核表达载体并在体外进行活性鉴定 ,为应用于瘢痕基因治疗奠定基础。方法 :设计并合成针对人组织 TIMP- 1 m RNA的锤头状核酶基因 Rz1 82、Rz35 8和 Rz4 1 2及相应的点突变核酶基因 ,将核酶基因克隆于可在体内高表达核酶的载体 p BSK-neo U 6中 ,制备嵌合于 U 6 sn RNA分子的核酶基因克隆。逆转录聚合酶链式反应获得全长 TIMP- 1 m RNA基因片段并克隆至T载体。体外转录法大量制备以 α- 32 P U TP标记的核酶及靶 RNA,进行体外切割实验。 结果 :核酶基因克隆制备正确 ,在体外成功转录出嵌合于 U6 sn RNA的核酶和靶 RNA。 37℃的生理温度下 ,U6 Rz1 82和 U6 Rz35 8成功切割了靶 RNA,U6 Rz1 82切割效率为 4 9.2 3% ,Km=2 9.7nmol/ L ,Kcat=0 .32 m in- 1 。 U 6 Rz35 8切割效率为 5 5 .2 1 %。 Km=39.6 nm ol/ L ,Kcat=0 .2 1min- 1。U6 Rz4 1 2及突变核酶均未显示切割活性。结论 :本研究中制备的 U6 Rz1 82和 U6 Rz35 8有良好的特异催化切割活性 ,有望在瘢痕成纤维细胞内抑制人 TIMP- 1的表达 。
文摘目的:分析真武汤联合曲美他嗪对慢性心力衰竭(CHF)患者血清氨基末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)水平和血流动力学的影响。方法:以2022年1月~2023年2月我院中医科收治的CHF患者84例为研究对象,采用随机数字表法分为对照组和观察组,各42例。对照组采用曲美他嗪进行治疗,观察组在对照组的基础上联合真武汤进行治疗,两组均治疗28d。比较两组治疗后疗效,治疗前和治疗28d后血清NT-proBNP、MMP-9、TIMP-1水平、心功能和血流动力学。结果:治疗28d后,观察组治疗总有效率为95.24%,显著高于对照组76.19%( P <0.05)。治疗28d后,两组血清NT-proBNP、MMP-9水平和左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、心率(HR)、外周血管阻力指数(PVRI)显著低于治疗前,且观察组显著低于对照组( P <0.05);而两组血清TIMP-1水平和左心室射血分数(LVEF)、心输出量(CO)、心脏指数(CI)、每搏输出量指数(SVI)显著高于治疗前,观察组显著高于对照组( P <0.05)。结论:真武汤联合曲美他嗪治疗CHF能显著降低患者血清NT-proBNP、MMP-9水平,升高血清TIMP-1水平,有效抑制患者心肌重塑,改善心功能和血流动力学,具有良好的治疗效果。
文摘Aims: Metalloproteinases are proteolytic enzymes, which decompose the extracellular matrix, influence cardiac remodelling, and are inhibited by tissue inhibitor of metalloproteinases(TIMPs). Little is known about the prognostic impact of the TIMP-1/matrix metalloproteinase complex in patients with future cardiovascular death. Methods and results: In 1979 patients with suspected coronary artery disease(CAD), TIMP-1 has been determined at baseline. Among 1945(98.4% ) patients with a mean follow-up period of 2.6± 1.2 years, 75 patients died because of cardiovascular causes. Mean concentrations of TIMP-1 were higher among patients who experienced a fatal cardiovascular event than among those who did not(820 vs. 692 ng/mL; P < 0.001). Age and sex adjusted hazard ratio of future cardiovascular death associated with one standard deviation of TIMP-1 level, was 1.37(95% CI: 1.17- 1.61; P < 0.001). The hazard ratio remained nearly identical after adjustment for clinical and therapeutic confounders. B-type natriuretic peptide(2.75, 95% CI: 1.94- 3.89; P < 0.001), C-reactive protein(1.79, 95% CI: 1.43- 2.24; P < 0.001), and TIMP-1(1.30, 95% CI: 1.07- 1.58; P=0.008) were independently associated with future cardiovascular death. Conclusion: In patients with CAD, TIMP-1 proves as an independent predictor for future cardiovascular death.
