比索洛尔对充血性心衰患者CGRP和ET_医学论文.docVIP

比索洛尔对充血性心衰患者CGRP和ET_医学论文 比索洛尔对充血性心衰患者CGRP和ET_医学论文 作者：王海燕，贾国良 ，郭文怡，何争，张清，郑晓荣 【关键词】 心力衰竭 　　【Abstract】 AIM: To study the effects of bisoprolol on plasma calcitonin gene related peptide (CGRP), endothelin (ET)1 levels and heart functions in patients with chronic heart failure．METHODS: Sixtyeight patients with chronic heart failure were divided into two groups: the bisoprolol group and the control group. Blood samples were drawn from median cubital veins of all these patients at the beginning of the study and followup after the 7month. The plasma concentration of ET1 and CGRP were detected by radioimmunoassay, and the left ventricular ejection fraction (EF%) were recorded to evaluate the effects of bisoprolol．RESULTS: At the end of 7month follow up, the plasma concentrations of ET1 and CGRP in bisoprolol group decreased significantly compared with those at the beginning of the study (0.01) and it was also true compared with those of the control group (0.01)．The values of EF% were higher in both groups after 7month followup, and the values of EF% was significantly higher in the bisoprolol group than those in the control group (all 0.01). CONCLUSION: Bisoprolol added to other routine drugs can decrease the levels of the plasma CGRP and ET1 and improve the heart functions of patients with heart failure. 　　【Keywords】 bisoprolol heart failure, congestive calcitonin gene related peptide endothelin1 ejection fraction 　　【摘要】 目的： 观察比索洛尔（bisoprolol）长期治疗充血性心衰患者后，血浆内降钙素基因相关肽（CGRP），内皮素（ET1）浓度变化和对心脏功能的影响．方法： 将符合本试验纳入标准的68例心衰患者分成试验组（n=30）和 对照组（n=38），患者均口服地高辛、ACEI制剂、血管扩张剂（非钙离子拮抗剂）和利尿剂等基本抗心衰药物，在此基础上试验组加服比索洛尔．测定患者试验初始时和服药7 mo后血浆CGRP和ET1的浓度及其心脏射血分数(ejection fraction，EF%)．结果： 随访7 mo后，试验组患者血浆中CGRP和ET1浓度较试验初显著性降低(0.01)，与对照组比较均明显降低(0.01)；复查心脏B超EF%平均值：对照组(34.0±3.5)%和试验组(42.0±3.2)%，与试验初比较两组均有显著的改善，而7 mo后试验组较对照组有显著的升高(0.01) . 结论： 在基本心衰治疗用药的基础上加用比索洛尔治疗7 mo后，可以降低血浆CGRP和ET1浓度，减轻有害因子的毒副作用，使心肌重塑过程得到缓解．加用比索洛尔治疗7mo后的心衰患者心功能改善更显著. 　　【关键词】 比索洛尔；心力衰竭，充血性；降钙素基因相关肽；内皮素1；心脏射血分数 　　0引言 　　现已明确，心力衰竭时神经激素的持