摘要
目的：探讨盐酸法舒地尔对冠状动脉慢血流（ CSF）患者血管内皮功能的影响。方法选择冠状动脉造影结果正常但是存在CSF现象的患者82例，按照随机的原则分为常规治疗组与法舒地尔组，每组各41例。常规治疗组给予拜阿司匹林、硝酸酯类、他汀等常规治疗；法舒地尔组在常规治疗的基础上加用盐酸法舒地尔治疗。观察治疗前、后2周两组之间及组内患者心绞痛疗效、冠状动脉血流速度（TIMI）、肱动脉血流介导内皮依赖性舒张功能（FMD）、血浆一氧化氮（NO）、内皮素1（ET-1）及Rho激酶I（ ROCKI）水平的变化。结果法舒地尔组治疗后患者心绞痛疗效总有效率为87．80％，常规治疗组总有效率为65．85％，差异有统计学意义（χ2＝68．176，P＜0．05）。法舒地尔组治疗后患者TIMI计帧、FMD均显著高于治疗前，差异均有统计学意义（ t值分别为4．37、4．43，P均＜0．05）；法舒地尔组患者治疗后血浆NO水平显著高于治疗前，差异有统计学意义（ t＝5．63，P＜0．01）；ROCKI、ET-1均显著低于治疗前，差异均有统计学意义（t 值分别为6．19、5．66，P 均＜0．01）。常规治疗组治疗后 NO、ROCKI、ET-1水平及FMD、TIMI计帧与治疗前相比，差异均无统计学意义（ P 均＜0．05）。法舒地尔组治疗后 NO [（36．17±7．64）μmol／L与（24．99±8．96）μmol／L]水平及FMD[（9．96±1．76）％与（5．86±1．45）％]、TIMI计帧（17．53±5．81与29．71±7．83）均较常规治疗组治疗后显著升高（t 值分别为4．06、4．18、5．41，P 均＜0．05），ROCKI[（19．57±1．33）μg／L 与（34．38±1．51）μg／L]、ET-1[（14．36±6．05） ng／L 与（20．95±6．57） ng／L]水平较常规治疗组治疗后显著降低（ t值分别为3．87、4．36，P均＜0．01）。结论盐酸法舒地尔能够显著改善CSF患者的血管内皮功能。
Objective To investigate the effect of fasudil on vascular endothelial function in patients with coronary slow flow（ CSF） . Methods Eighty-two patients with CSF and normal coronary angiography were selected and randomly divided into conventional treatment group and fasudil group, 41 cases in each group. Patients in conventional treatment group were given conventional treatment（ aspirin,nitrates and atorvasta-tin） ,while patients in the fasudil group were given fasudil on the basis of conventional treatment. The angina pectoris,TIMI,endothelial-dependent flow-mediated vasodilation（ FMD） ,the levels of plasma nitric oxide（ NO） , endothelin-1（ ET-1） and Rho kinase（ ROCKI） of the brachial artery were observed in the two groups before and after two weeks of treatment. Results The total effective rate of fasudil group was 87. 80%,higher than that of conventional treatment group of 65. 85%,the difference was significant（χ2=68. 176,P〈0. 05） . TIMI,FMD im-proved in the fasudil group after treatment compared with before treatment, the difference was significant （ t=4. 37,4. 43;P〈0. 05）;plasma NO level increased compared with before treatment（t=5. 63,P〈0. 01）,while ROCKI,ET-1 level decreased（t=6. 19,5. 66;P〈0. 01）. Plasma NO,ET-1,ROCKI and FMD,TIMI of conven-tional treatment had no significantly changes before and after treatment（P〈0. 05）. The post-treatment of NO, FMD,TIMI levels in fasudil group were significantly increased compared with conventional group （ （ 36. 17 ±7. 64） μmol/L vs. （24. 99±8. 96） μmol/L,（9. 96±1. 76）% vs. （5. 86±1. 45）%,17. 53±5. 81 vs. 29. 71 ±7. 83;t=4. 06,4. 18,5. 41;P〈0. 05）,while ROCKI,ET-1 levels in fasudil group were significantly decreased compared with conventional group（（19. 57±1. 33） μg/L vs. （34. 38±1. 51） μg/L,（14. 36±6. 05） ng/L vs. （20. 95±6. 57） ng/L;t=3. 87,4. 36,P〈0. 01）. Conclusion Fasudil can significantly improve the vascular en-dothelial function in patients with CSF.
出处
《中国综合临床》
2016年第10期868-871,共4页
Clinical Medicine of China
基金
济宁市医药卫生科技发展计划项目（2015-57-109）
