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目的探讨卡维地洛对高血压心脏病患者的M2-乙酰胆碱能受体自身抗体的影响。方法 2011年1月至2012年1月期间,我院诊治的74例高血压心脏病患者,随机将其分为对照组(常规治疗)和观察组(对照组基础上,加用卡维地洛),平均随访半年,对两组患者的心功能,以及M2-乙酰胆碱能受体自身抗体的变化情况,进行观察和比较。结果与治疗前相比,治疗后两组LVEDD、LVESD、LVEF,以及心功能均有所改善。与治疗后对照组相比,观察组心功能分级、LVEDD、LVESD明显降低,而LVEF升高,血清中M2-乙酰胆碱受体自身抗体滴度明显降低,P<0.05,有统计学意义。结论 M2-乙酰胆碱受体与高血压心脏病的发病过程有着密切的联系,卡维地洛通过阻断M2-乙酰胆碱受体自身抗体对心脏的不利影响,发挥心脏保护作用。
Objective To investigate the effect of carvedilol on M2-acetylcholine receptor autoantibodies in patients with hypertensive heart disease. Methods From January 2011 to January 2012, 74 patients with hypertensive heart disease diagnosed and treated in our hospital were randomly divided into control group (conventional treatment) and observation group (control group, plus carvedilol ) Were followed up for an average of six months. The changes of cardiac function and autoantibodies to M2-acetylcholine receptor in two groups were observed and compared. Results Compared with those before treatment, LVEDD, LVESD, LVEF and cardiac function were improved in both groups after treatment. Compared with the control group after treatment, heart function grading, LVEDD and LVESD in the observation group were significantly decreased, while the LVEF was increased. The titers of M2-AChR antibody in the serum were significantly decreased (P <0.05). Conclusions There is a close relationship between M2-acetylcholine receptor and the pathogenesis of hypertensive heart disease. Carvedilol exerts cardioprotection by blocking the adverse effects of M2-acetylcholine receptor autoantibodies on the heart.