免疫調節剤ペントキシフィリンによる缺血性心筋病症の治療:ランダム化試験の結果

Karen Sliwa¹, Angela Woodiwiss, Veuvette N Kone

¹Department of Cardiology, Chris-Hani Baragwanath Hospital, Johannesburg, South Africa.

Circulation

|February 19, 2004

まとめ

ペントキシフィリンは,心筋不全症患者の心臓機能を改善し,炎症マーカーを減少させた. この心不全治療は,臨床的状態とエジェクション分数を向上させ,新たな治療の道を開きました.

科学分野:

心臓病学心臓病学
免疫学免疫学とは
薬理学薬理学とは

背景:

炎症性免疫活性化は心不全において一般的であり,その状態を悪化させる可能性があります.
免疫調節剤の研究は,心不全の新たな治療戦略を提示する可能性がある.
ペントキシフィリン (Pentoxifylline) は,心血管疾患における潜在的な利点を持つ免疫調節剤です.

研究の目的:

ペントキシフィリンが,不全性心筋症患者の左心室機能を改善するかどうかを判断する.
ペントキシフィリンが炎症マーカー,予後マーカー,アポトーシスマーカーに及ぼす効果を評価する.
心不全の標準治療に対する補助療法としてペントキシフィリンを評価する.

主な方法:

予見性,ランダム化,ダブルブラインド,プラセボ対照試験.
発血性心筋症の38人の患者は,ペントキシフィリンまたはプラセボを6ヶ月間投与された.
評価された臨床的評価,放射性核酸心室撮影,心声撮影,血液分析.

主要な成果:

ペントキシフィリンは,機能的クラス,静脈動脈血圧,左心室排泄分子を改善しました.
C反応性タンパク質 (CRP),NT-pro BNP,腫瘍死滅因子アルファ (TNF-alpha),およびFas/Apo-1の有意な減少が観察されました.
プラセボ群と比較して,ペントキシフィリン群では死亡者が少なくなりました.

結論:

ペントキシフィリンは,左心室機能不全による心不全患者の臨床状態と心臓機能を改善します.
ペントキシフィリンによる治療は,炎症,予後,アポトーシスマーカーの血濃度の低下につながる.
ペントキシフィリンは,不全性心筋病の管理のための標準療法への有望な追加です.

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