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目的探讨不同剂量培哚普利对慢性心力衰竭患者血浆miR-423-5p表达的影响及与心功能之间的相关性。方法选取慢性心力衰竭患者75例,随机分为常规组(常规药物治疗)、小剂量组(常规药物+4 mg/d培哚普利)和大剂量组(常规药物+8 mg/d培哚普利),每组25例。选取同期健康查体心功能正常人群25例(正常对照组)。经药物治疗4周,检测各组治疗前后左室舒张末内径(LVEDD)、左室射血分数(LVEF)、氨基末端脑利钠肽前体(NT-pro BNP)及血浆miR-423-5p的表达水平。结果基线水平常规组、小剂量组、大剂量组LVEF的表达均显著低于正常对照组(P<0.05),LVEDD、NT-pro BNP及血浆miR-423-5p的表达均显著高于正常对照组(P<0.05);治疗4周后常规组、小剂量组、大剂量组LVEF的表达均较治疗前显著升高(P<0.05),LVEDD、NT-pro BNP、血浆miR-423-5p的表达均较治疗前显著降低(P<0.05);治疗后小剂量组和大剂量组LVEF的表达均显著高于常规组(P<0.05),LVEDD、NT-pro BNP、血浆miR-423-5p的表达均显著低于常规组(P<0.05);同时,与小剂量组比较,大剂量组LVEF、LVEDD、NT-pro BNP、血浆miR-423-5p的表达水平变化呈显著差异(P<0.05)。结论培哚普利可以降低慢性心力衰竭患者血浆miR-423-5p的表达水平,进而改善左室功能,其改善程度与药物剂量呈正相关。
Objective To investigate the effect of different doses of perindopril on the expression of plasma miR-423-5p in patients with chronic heart failure and its correlation with cardiac function. Methods Seventy-five patients with chronic heart failure were randomly divided into two groups: conventional group (conventional drug treatment), low-dose group (conventional drug + 4 mg / d perindopril) and high-dose group Puli), 25 cases in each group. Twenty-five healthy people with normal cardiac function were enrolled in the same period (normal control group). After treatment for 4 weeks, the left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NT-proBNP and plasma miR-423-5p The level of expression. Results The levels of LVEF in the normal group, low-dose group and high-dose group were significantly lower than those in the normal control group (P <0.05), and the expressions of LVEDD, NT-pro BNP and plasma miR-423-5p were significantly higher than those in the normal control (P <0.05). After 4 weeks of treatment, the expression of LVEF in normal group, low dose group and high dose group were significantly higher than those before treatment (P <0.05). The LVEDD, NT-pro BNP, plasma miR-423-5p (P <0.05). After treatment, the expression of LVEF in low-dose group and high-dose group were significantly higher than those in the conventional group (P <0.05). LVEDD, NT-pro BNP and plasma miR-423- (P <0.05). At the same time, compared with the low-dose group, the expression levels of LVEF, LVEDD, NT-pro BNP and plasma miR-423-5p in the high dose group were significantly different (P <0.05). Conclusion Perindopril can reduce the expression of plasma miR-423-5p in patients with chronic heart failure and further improve the left ventricular function. The improvement is related to the dosage of perindopril.