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目的探讨老年慢性心衰(ECHF)患者雄激素水平减低对细胞因子的影响及药物干预作用。方法将60例ECHF患者随机分为治疗组和对照组,每组各30例。于治疗前及治疗2个月后分别检测血液总睾酮(TT)、游离睾酮(FT)、血浆sFas、肾上腺髓质素(ADM)和脂联素水平,对照组采用常规治疗,治疗组采用薯蓣皂甙80mgtid+卡维地洛5mgbidpo。结果ECHF时FT明显减低,血清脂联素降低,血浆sFas和ADM明显增加。脂联素与FT呈正相关(r=0.5,P<0.01),与血浆sFas及ADM呈现负相关(r=-0.45,r=-43,P<0.05)。治疗组治疗后与对照组比较血清脂联素明显增加,左室收缩功能改善,血浆sFas及ADM水平明显降低(P<0.01)。结论FT水平减低可影响心肌细胞凋亡,ADM明显升高可能与ADM抵抗相关。血浆sFas及脂联素水平与内皮细胞功能之间存在一定的相关性。
Objective To investigate the effects of androgen deprivation on cytokines and drug intervention in elderly patients with chronic heart failure (ECHF). Methods Sixty patients with ECHF were randomly divided into treatment group and control group, with 30 cases in each group. The levels of total testosterone (TT), free testosterone (FT), plasma sFas, adrenomedullin (ADM) and adiponectin in the blood were measured before treatment and 2 months after treatment, respectively. Saponin 80mgtid + carvedilol 5mgbidpo. Results FT decreased significantly when ECHF, serum adiponectin decreased, plasma sFas and ADM increased significantly. There was a positive correlation between adiponectin and FT (r = 0.5, P <0.01) and a negative correlation with plasma sFas and ADM (r = -0.45, r = -43, P <0.05). Compared with the control group, serum adiponectin, left ventricular systolic function and plasma sFas and ADM levels in the treatment group were significantly decreased (P <0.01). Conclusion The decrease of FT level may affect the apoptosis of cardiomyocytes. The increase of ADM may be related to the resistance of ADM. Plasma sFas and adiponectin levels and endothelial cell function there is a certain correlation between.