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目的探讨1,6-二磷酸果糖(FDP)对老年慢性心力衰竭患者血浆肾素血管紧张素系统(RAS)、内皮素(ET)、细胞因子(TNF)水平的影响。方法67例老年慢性心衰患者(CHF)随机分为A组(33例)B组(34例),A组采用常规抗心衰药物治疗,B组在常规治疗的基础上加用FDP10g静脉滴注,1次/d,疗程14d,采用放免法测定两组治疗前后血浆肾素(PRA)、血管紧张素Ⅱ(AgⅡ)、内皮素(ET)和血清肿瘤坏死因子(TNF)水平,超声心动图测定治疗前后心功能,并以30例健康老人为对照(对照组)。结果A、B两组CHF患者治疗前PRA、AgⅡ、ET、TNF水平与对照组比较均显著升高,治疗后PRA、AgⅡ水平明显上升,ET、TNF水平显著下降;左室短轴缩短率(FS),E峰速度(PEV),E/A比值亦明显改善。但B组较A组改善更明显,并且差异有统计学意义(P<0.05)。结论AgⅡ、ET、TNF等神经激素、细胞因子参与了老年慢性心衰的发生发展过程,1,6-二磷酸果糖可通过调节内皮细胞舒缩功能,改善心功能。
Objective To investigate the effects of fructose-1,6-diphosphate (FDP) on plasma renin-angiotensin system (RAS), endothelin (ET) and cytokines (TNF) levels in elderly patients with chronic heart failure. Methods Sixty-seven elderly patients with chronic heart failure (CHF) were randomly divided into group A (n = 33), group B (n = 34), group A with conventional anti-heart failure drug treatment, group B The levels of plasma renin (PRA), angiotensin Ⅱ (Ⅱ), endothelin (ET) and serum tumor necrosis factor (TNF) were measured before and after treatment by radioimmunoassay (RIA) Figure determination of cardiac function before and after treatment, and 30 healthy controls (control group). Results The levels of PRA, AgⅡ, ET and TNF in patients with CHF before and after treatment were significantly higher than those in the control group. The levels of PRA and AgⅡ were significantly increased and the levels of ET and TNF were significantly decreased after treatment. The shortening rate of left ventricular short axis FS), E peak velocity (PEV), E / A ratio also significantly improved. However, group B improved more obviously than group A, and the difference was statistically significant (P <0.05). Conclusion Neurokines such as AgⅡ, ET, TNF and cytokines are involved in the development of chronic heart failure in the elderly. Fructose-1,6-diphosphate can improve cardiac function by regulating the vasomotor function of endothelial cells.