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目的观察卡维地洛对老年慢性心力衰竭(chronic heart failure,CHF)患者血清基质金属蛋白酶-2(matrixmetallo proteinases,MMP-2)水平的影响,探讨卡维地洛治疗CHF的可能机制。方法选择确诊的老年CHF 200例,随机分为对照组和治疗组,每组各100例。两组均予呋塞米、血管紧张素转换酶抑制剂及洋地黄等常规治疗,治疗组在此基础上予卡维地洛治疗。同时选择健康体检者50例作为正常对照组。采用酶标多克隆抗体夹心法测定正常对照组及治疗组、对照组治疗前、治疗后3个月MMP-2水平,同时测定左室射血分数(LVEF)。结果治疗前治疗组和对照组血清MMP-2水平均明显高于正常对照组,LVEF较正常对照组低,差异均有统计学意义(P<0.05)。与治疗前相比,治疗组和对照组治疗后3个月血清MMP-2水平明显降低,LVEF明显升高,差异亦均有统计学意义(P<0.05)。治疗后3个月治疗组和对照组比较血清MMP-2水平明显降低,LVEF显著升高,差异有统计学意义(P<0.05)。结论对血清MMP-2水平的影响可能是卡维地洛改善CHF患者心室重塑及心功能的机制之一。
Objective To investigate the effect of carvedilol on the serum level of matrixmetallo proteinases (MMP-2) in elderly patients with chronic heart failure (CHF) and to explore the possible mechanism of carvedilol in the treatment of CHF. Methods 200 cases of elderly CHF were selected and randomly divided into control group and treatment group with 100 cases in each group. Both groups were given furosemide, angiotensin-converting enzyme inhibitors and digitalis and other conventional treatment, the treatment group on this basis to be carvedilol treatment. At the same time, 50 healthy people were selected as normal control group. The levels of MMP-2 in the normal control group and the treatment group and the control group before treatment and 3 months after treatment were determined by enzyme-linked polyclonal antibody sandwich method, and the left ventricular ejection fraction (LVEF) was also measured. Results Before treatment, the levels of serum MMP-2 in the treatment group and the control group were significantly higher than those in the normal control group, and the LVEF was lower than that in the normal control group (P <0.05). Compared with those before treatment, serum MMP-2 level and LVEF in treatment group and control group were significantly decreased 3 months after treatment (P <0.05). At 3 months after treatment, serum MMP-2 level was significantly lower and LVEF was significantly higher in the treatment group and the control group (P <0.05). Conclusion The effect on serum MMP-2 level may be one of the mechanisms of carvedilol improving ventricular remodeling and cardiac function in patients with CHF.