卡维地洛对非梗阻性肥厚型心肌病患者心室重构的影响

摘要

目的 观察卡维地洛对肥厚型心肌病患者心室重构的影响.方法 将35例肥厚型心肌病患者随机分为卡维地洛组(21例)与对照组(14例),两组均予常规治疗,卡维地洛组加用卡维地洛,疗程4个月,并随访至半年.检测两组治疗前后氧化应激、炎症、超声及基质金属蛋白酶2(MMP-2)和特异性组织抑制剂2(TIMP-2)的改变情况以及半年内的不良心血管事件.结果 治疗后两组氧化应激、炎症均较治疗前显著降低,心室重构减缓(P＜0.05),而卡维地洛组尤为明显(P＜0.01).相比对照组,卡维地洛组的半年心血管不良事件更低(P＜0.05).结论 卡维地洛可降低氧化应激、炎症,减缓肥厚型心肌病患者心室重构,减少心血管不良事件的发生.%Objective To investigate the effects of carvedilol on ventricular remodeling in patients with hypertrophic non-obstructive cardiomyopathy (HNCM).Methods Totally 35 patients with HNCM were randomly divided into the carvedilol group (n =21) and the control group(n =140).Each group was given traditional treatment while the carvedilol group was additionally treated with carvedilol for 4 months.The oxidative stress,inflammatory markers,echocardiography,matrix metalloproteinase 2 (MMP-2),tissue inhibits of metalloproteinase-2 (TIMP-2) werc detcctcd in both groups before and after treatment.All patients were followed up to 6 months.Results After treatment,the oxidative stress,serum level of inflammatory cytokines and ventricular remodeling were improved (P ＜ 0.05),especially in the carvedilol group (P ＜ 0.01).Compared to the control group,lower cardiovascular adverse events were occurred in the carvedilol group (P ＜ 0.05).Conclusion Carvedilol can lower oxidative stress,serum level of inflammatory cytokine,reverse ventricular remodeling and reduce adverse cardiovascular events in patients with HNCM.