美托洛尔对心力衰竭β受体相关信号通路及心功能的影响.pdfVIP

· 4l0 · South China Joumal of Cardiovascular Diseases．December 2007．V0I 13．No6 美托洛尔对心力衰竭l3受体相关信号通路及 心功 能的影响 孙梅芹，侯凯文，闫 翔，林 杭，王 健 (成都军区总医院心血管内科，成都 610083) 摘要： 目的 探讨p。受体阻断药美托洛尔对慢性心力衰竭病人B受体相关信号通路及心功能的干预 机制。方法 选择慢性心功能不全病人95例，分为常规治疗组45例和美托洛尔治疗组50例。美托洛 尔逐渐递增至最大剂量100 mg，每日2次或最大耐受剂量，治疗6个月，复查彩色多普勒心动图。测 定左心室舒张末内径、左心房内径、左心室射血分数和心胸比例。反转录聚合酶链反应检测血淋巴细胞 p 受体、p：受体、 受体mRNA表达，复查血浆环磷腺苷、环磷鸟苷、一氧化氮合酶、诱导型一氧化 氮合酶和一氧化氮含量。结果 美托洛尔治疗组及常规治疗组治疗6个月，病人心功能明显改善，左心 室射血分数升高。美托洛尔组心胸比例、左心室舒张末内径的和左心房内径明显减少。血浆环磷腺苷、 环磷鸟苷、一氧化氮合酶、诱导型一氧化氮合酶和一氧化氮含量明显降低。结论 美托洛尔通过调节B 受体相关信号通路．改善慢性心功能不全病人的心功能。 关键词：心力衰竭，充血性；B受体；信号转导；美托洛尔 中图分类号：R541．6+1；R97T．4 文献标识码：A 文章编号：1007—9688(2007)o6—0410—04 EllFt t of metoprolol on signaling pathways of p-adrenergic receptors and heart function in patients with congestive heart failure SUN Mei-qin，HOU Kai—wen，YAN Xiang，LIN Hang，WANG Jian (Department of Cardiology，rIhe General Hospital of Chengdu Army Region，Chengdu Shichuan 610083． China) Abstract： Objectives To investigate the effects of pl-blockers on the p-adrenoreceptor signaling pathway and its interference on heart function．Methods Ninety-five patients with congestive heart failure were randomly divided into two groups， namely conventional therapy group and metroprolol—treated group．Metroprolol-treated group was started on metoprolol 6．25 mg bid and titrated to 100 mg bid up to m~imum dose or m~imum tolerated dose．1eft ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDd) were measured by echoeardiography， the varieties of the levels of Bl， p2， p3-adrenoceptor mRNA in lymphocyte were measured by RT-PCR，concentrations of cyclic adenosine monomphsopate (cAMP)and cyclic guanosine monophosphate (cGMP)in plasma were determined by radioimmunoassay， nitric oxide synthase (NOS)， inducible nitric s~thase (INOS)and nitric oxide (NO)were measured by biochemical analysis before and after 6 months treatment． Results