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目的研究充血性心力衰竭(CHF)患者应用盐酸贝那普利、氯沙坦、盐酸贝那普利联合氟沙坦对调节细胞外基质降解,改善心肌重构的作用。方法将90例CHF患者随机分为盐酸贝那普利治疗组、氯沙坦治疗组、盐酸贝那普利+氯沙坦治疗组(盐酸贝那普利10mg/d,氯沙坦50mg/d,共用8周);于治疗前后分别测定血清基质金属蛋白酶(MMP)-1、MMP-9、基质金属蛋白酶抑制因子(TIMP)-1、TIMP-4水平。结果经盐酸贝那普利、氯沙坦治疗8周后,三组血清MMP-1、MMP-9水平均明显降低:TIMP-1水平明显上升.且盐酸贝那普利+氯沙坦治疗组较另二组上升水平明显增加;血清TIMP-4水平无显著性差异。结论在CHF患者中加用盐酸贝那普利、氯沙坦能调节MMPs、TIMPs水平,从而更有效地改善心肌重构。
Objective To investigate the effects of benazepril hydrochloride, losartan and benazepril combined with fluvastatin on the regulation of extracellular matrix degradation and myocardial remodeling in patients with congestive heart failure (CHF). Methods 90 CHF patients were randomly divided into benazepril hydrochloride group, losartan group, benazepril hydrochloride group and losartan group (benazepril hydrochloride 10mg / d, losartan 50mg / d For 8 weeks). Serum levels of matrix metalloproteinase (MMP) -1, MMP-9, TIMP-1 and TIMP-4 were measured before and after treatment. Results After treatment with benazepril and losartan for 8 weeks, the levels of serum MMP-1 and MMP-9 were significantly decreased: the level of TIMP-1 was significantly increased, and the benazepril hydrochloride and losartan treatment groups Compared with the other two groups increased significantly; serum TIMP-4 levels no significant difference. Conclusions In patients with CHF, benazepril and losartan can regulate the levels of MMPs and TIMPs and thus improve myocardial remodeling more effectively.