Ma Qi-lin, Xie Yong, Zhang Sai-dan
Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
Hunan Yi Ke Da Xue Xue Bao. 2002 Dec 28;27(6):527-9.
To investigate the level of serum superoxide dismutase (SOD) and maiondialdehyde (MDA) and left ventricular systolic function in congestive heart failure (CHF) and to evaluate the influence of trimetazidine on them.
Serum SOD and MDA were measured in 50 patients with heart function from grade two to four and 15 normal subjects. All the persons underwent echocardiography to determine the left ventricular end-systolic volume index (LVESVI) and the left ventricular ejection fraction (EF). The patients with CHF were randomly treated with trimetazidine plus routine therapy (n = 25) or routine therapy only (n = 25) for 8 weeks with evaluations made before and after the treatment.
The SOD level and EF in the patients with CHF significantly decreased and the MDA level and LVESVI in those patients significantly increased compared with the normal subjects (P < 0.05); the severer the CHF, the greater the changes. After the treatment, the SOD level and EF increased significantly and MDA and LVESVI decreased significantly (P < 0.01) in both the trimetazidine and the conventional groups. And these changes were more obvious in the trimetazidine group than in the conventional group(P < 0.01).
Oxygen free radicals play an important role in the pathophysiologic changes of CHF. The level of serum SOD and MDA can indicate the degree of CHF. Trimetazidine not only increases the level of SOD and decreases the level of MDA, but also improves the left ventricular systolic function.
探讨充血性心力衰竭(CHF)患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平及左心室收缩功能,并评估曲美他嗪对其的影响。
测定50例心功能Ⅱ至Ⅳ级的患者及15例正常受试者的血清SOD和MDA水平。所有受试者均接受超声心动图检查,以确定左心室收缩末期容积指数(LVESVI)和左心室射血分数(EF)。CHF患者随机分为曲美他嗪加常规治疗组(n = 25)和单纯常规治疗组(n = 25),治疗8周,治疗前后进行评估。
与正常受试者相比,CHF患者的SOD水平和EF显著降低,MDA水平和LVESVI显著升高(P < 0.05);CHF越严重,变化越大。治疗后,曲美他嗪组和常规治疗组的SOD水平和EF均显著升高,MDA和LVESVI均显著降低(P < 0.01)。且曲美他嗪组的这些变化比常规治疗组更明显(P < 0.01)。
氧自由基在CHF的病理生理变化中起重要作用。血清SOD和MDA水平可反映CHF的严重程度。曲美他嗪不仅能提高SOD水平、降低MDA水平,还能改善左心室收缩功能。