论文部分内容阅读
目的 :探讨充血性心力衰竭 (CHF)患者血浆可溶型TNF相关的凋亡诱导配体 (sTRAIL)和死亡受体DR5水平的变化及与培哚普利对心脏保护的关系。方法 :用ELISA法检测治疗前后 30例服用培哚普利的CHF患者、2 8例常规治疗的CHF患者及 2 0例健康人对照血浆中sTRAIL及sDR5的水平。结果 :① 5 8例CHF患者血浆sTRAIL的平均含量为 (1.4 3± 0 .4 7)μg/L ,健康人为 (0 .93± 0 .12 ) μg/L ,两者无显著性差异(P >0 .0 5 ) ;sTRAIL水平与心功能损害程度亦无明显关系。CHF患者血浆sDR5的平均含量为 (39.6 7± 6 .78)ng/L ,较健康人 (<6ng/L)明显升高 ,且随着心功能损害程度的加重而升高。②培哚普利组与常规心衰治疗组治疗后 ,血浆中sTRAIL的水平均有所降低 ,但无显著性差异。治疗前后培哚普利组血浆sDR5的平均水平 ,分别为 (31.2 3± 10 .16 )ng/L和 (8.5 0± 2 .14 )ng/L(P <0 .0 5 ) ;常规治疗组分别为 (48.81± 8.74 )ng/L和 (2 6 .6 4± 6 .2 7)ng/L(P <0 .0 5 )。培哚普利组与常规治疗组相比较 ,前者降低更明显 (分别下降 72 .7%和 4 5 .4 % )。③与其他病因所致CHF患者相比较 ,高血压心脏病所致CHF患者血浆sDR5的水平明显升高。结论 :sDR5可能在CHF患者心肌细胞凋亡的发生、发展中起着重要作用。培哚普利可降低C
Objective: To investigate the changes of plasma soluble TNF-related apoptosis-inducing ligand (sTRAIL) and death receptor DR5 in patients with congestive heart failure (CHF) and the relationship with perindopril on cardioprotection. Methods: Serum levels of sTRAIL and sDR5 in 30 patients with CHF before and after perindopril treatment, 28 CHF patients with routine treatment and 20 healthy controls were measured by ELISA. Results: ① The mean plasma levels of sTRAIL in 58 CHF patients were (1.4 3 ± 0.47) μg / L and those in healthy subjects were (0.93 ± 0.12) μg / L, respectively, with no significant difference (P > 0. 05). The level of sTRAIL also had no significant correlation with the degree of cardiac dysfunction. The mean level of sDR5 in CHF patients was (39.6 7 ± 6. 78) ng / L, which was significantly higher than that in healthy people (<6ng / L) and increased with the severity of cardiac dysfunction. ② Perindopril group and conventional heart failure treatment group after treatment, plasma sTRAIL levels were reduced, but no significant difference. The mean levels of sDR5 in perindopril group before and after treatment were (31.2 3 ± 10.16) ng / L and (8.5 0 ± 2.14) ng / L, respectively (P 0. 05) (48.81 ± 8.74) ng / L and (26.46 ± 6.27) ng / L, respectively (P <0.05). Compared with the conventional treatment group, the former decreased more obviously (decreased by 72.7% and 45.4% respectively) in the perindopril group. ③ Compared with CHF patients caused by other etiologies, plasma sDR5 levels in patients with CHF caused by hypertension were significantly higher. Conclusion: sDR5 may play an important role in the development of cardiomyocyte apoptosis in CHF patients. Perindopril reduces C