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目的研究心力衰竭 (心衰 )患者在卡托普利治疗前、后细胞调亡抑制物血浆可溶性Fas(sFas)水平的变化 ,以及与NYHA心功能分级的关系。方法 42例心力衰竭患者 ,随机分为常规治疗组和卡托普利治疗组 ,进行药物干预共 4周 ,检测治疗前、后血浆sFas水平。健康对照组 2 9例 ,同时检测血浆sFas。结果心力衰竭患者血浆sFas水平升高 ,与对照组比较有明显差异[对照组 (6 .1 7± 2 .0 1 )ng/ml,心衰组 (1 6 .55± 9.4)ng/ml,P <0 .0 1 ]。心功能Ⅱ级组 (1 0 .76± 5 .32 )ng/ml,Ⅲ级组(1 3 .1 1± 4 .42 )ng/ml,Ⅳ级组 (2 4 .0 2± 1 0 .67)ng/ml,Ⅳ级组与Ⅱ、Ⅲ级组比较 ,P <0 .0 1。卡托普利治疗后血浆sFas明显降低 [治疗前(1 7.2 5± 9.96)ng/ml,治疗后 (1 4 .59± 8.48)ng/ml,P <0 .0 1 ) ] ,而常规治疗组治疗前、后无明显差异。结论心衰患者血浆sFas升高 ,并与心衰的严重程度呈正相关 ,推测sFas参与了心衰的发生和发展 ;卡托普利有降低sFas的作用。
Objective To study the changes of plasma soluble Fas (sFas) levels in patients with heart failure (CHF) before and after captopril treatment and the relationship with NYHA functional classification. Methods Forty-two patients with heart failure were randomly divided into routine treatment group and captopril treatment group, and drug intervention was performed for 4 weeks. Plasma sFas levels were measured before and after treatment. Healthy control group, 29 cases, while testing plasma sFas. Results The level of plasma sFas in patients with heart failure was significantly higher than that in the control group [(6.71 ± 2.01) ng / ml in control group, (16.55 ± 9.4) ng / ml in heart failure group, P <0 .0 1]. Grade Ⅱ group (10.76 ± 5.32) ng / ml, grade Ⅲ group (13.1 ± 4.42) ng / ml, grade Ⅳ group (24.02 ± 1.03) 67) ng / ml, Ⅳ grade group and Ⅱ, Ⅲ grade group, P <0. Captopril plasma sFas was significantly lower (before treatment (7.2 ± 9.96) ng / ml, after treatment (14.5 ± 8.48) ng / ml, P <0.01) Group before treatment, no significant difference. Conclusions Plasma sFas is elevated in patients with heart failure and is positively correlated with the severity of heart failure. It is speculated that sFas is involved in the occurrence and development of heart failure. Captopril may reduce sFas.