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[卡维地洛对慢性心力衰竭患者凋亡基因PDCD5表达的影响]

[The effect of carvedilol on apoptosis gene PDCD5 expression in chronic heart failure patients].

作者信息

Wu Yan, Nie Xiao-Yun, Hu Da-Yi, Lu Pi-Neng, Zhang Guo-Qiang, Luo Lan

机构信息

People's Hospital, Peking University, Beijing 100044, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 Mar 16;85(10):676-8.

Abstract

OBJECTIVE

To observe the changes of serum PDCD5 antibody in chronic ischemic heart failure patients and the effect of carvedilol treatment.

METHODS

Twenty chronic ischemic heart failure patients, 11 males and 9 females, aged 58 +/- 13, with the left ventricular ejection fraction (LVEF) < 45% by echocardiography and New York Heart Association (NYHA) cardiac function classification II-III, were treated with carvedilol for 6 months with a target dosage of 50 mg/d. The serum PDCD5 antibody was tested by ELISA before and after carvedilol treatment and compared with those of 20 healthy persons.

RESULTS

The A value of PDCD5 antibody in the heart failure patients was 3.5 +/- 1.4, significantly higher that in than healthy persons (1.9 +/- 1.0, P < 0.01). After treatment of carvedilol, the A value of PDCD5 antibody in the heart failure patients decreased to 2.5 +/- 1.2 (P < 0.05). In 6 months maintenance treatment, 14 (70%) patients reached the dosage 50 mg/d, 4 (20%) reached 25 mg/d, and 2 (10%) reached 12.5 mg/d. Five patients (25%) had side effect such as dizziness, nausea and cough, one patient (5%) was hospitalized for 3 weeks because of heart failure, no patient died. After treatment of carvedilol, the NYHA degree increased by 0.3 (P < 0.05), LVEF increased from 35.5% +/- 7.8% to 42.7% +/- 9.6% (P < 0.05), left ventricular end-diastolic diameter decreased 5.3 mm (P < 0.05), and left ventricular end-systolic diameter decreased by 8.1 mm (P < 0.01).

CONCLUSION

The titer of apoptosis gene PDCD5 antibody in the serum of chronic ischemic heart failure patients are higher, which shows apoptosis and treatment of carvedilol significantly decreases its titer.

摘要

目的

观察慢性缺血性心力衰竭患者血清程序性死亡分子5(PDCD5)抗体的变化及卡维地洛治疗的效果。

方法

选取20例慢性缺血性心力衰竭患者,男11例,女9例,年龄58±13岁,经超声心动图检查左心室射血分数(LVEF)<45%,纽约心脏病协会(NYHA)心功能分级为Ⅱ-Ⅲ级,给予卡维地洛治疗6个月,目标剂量为50mg/d。采用酶联免疫吸附测定(ELISA)法检测卡维地洛治疗前后患者血清PDCD5抗体,并与20例健康人进行比较。

结果

心力衰竭患者PDCD5抗体A值为3.5±1.4,显著高于健康人(1.9±1.0,P<0.01)。卡维地洛治疗后,心力衰竭患者PDCD5抗体A值降至2.5±1.2(P<0.05)。在6个月的维持治疗中,14例(70%)患者达到50mg/d剂量,4例(20%)达到25mg/d,2例(10%)达到12.5mg/d。5例患者(25%)出现头晕、恶心、咳嗽等副作用,1例患者(5%)因心力衰竭住院3周,无患者死亡。卡维地洛治疗后,NYHA分级提高0.3(P<0.05),LVEF从35.5%±7.8%增至42.7%±9.6%(P<0.05),左心室舒张末期内径减小5.3mm(P<0.05),左心室收缩末期内径减小8.1mm(P<0.01)。

结论

慢性缺血性心力衰竭患者血清凋亡基因PDCD5抗体滴度较高,提示存在细胞凋亡,卡维地洛治疗可显著降低其滴度。

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