经皮冠状动脉介入治疗术后血管内皮的变化及药物的保护作用  

Protective effect of adenosine on vascular endothelial cells after percutaneous coronary intervention

作　　者：杨春梅[1] 刘兵[1] 范宝晶[2] 赵学忠[3] 闫立敏[1] 

机构地区：[1]武警吉林总队医院,长春130052 [2]长春市中心医院,长春130051 [3]吉林大学白求恩医学部第一临床医院心内科,长春130021

出　　处：《武警医学》2008年第1期57-60,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察急性心肌梗死(AMI)患者经皮冠状动脉介入治疗术(PCI)后血管内皮细胞(VEC)的改变及腺苷与硝酸甘油的保护作用。方法对60例AMI行PCI的患者随机分成3组:腺苷组、硝酸甘油组和对照组。3组患者在行PCI罪犯血管开通后分别立即给予冠脉内注射:腺苷组:腺苷注射液240μg+生理盐水10ml。硝酸甘油组:硝酸甘油200μg+生理盐水10ml。对照组:生理盐水10ml。3组患者皆测定用药前后冠状动脉血浆血管性血友病因子(vWF)、一氧化氮(NO)含量,同时测定血管开通即刻和用药后5min冠脉血流帧数。结果3组患者vWF在术后均高于术前含量(P<0.05)。但腺苷组和硝酸甘油组vWF含量明显低于对照组(P<0.05)。3组患者在术后NO血浆含量均明显低于术前(P<0.05),但术后腺苷组和硝酸甘油组NO含量明显高于对照组(P<0.05)。冠脉给药后5min冠脉血流计帧数腺苷组较对照组明显减少(P<0.05)。结论PCI可造成血管内皮的功能损伤,PCI术后冠脉内应用腺苷与硝酸甘油对病变血管内皮功可能有保护作用。Objective To study the protective effect of adenosine on vascular endothelial cells （VEC） in patients with acute myocardial infarction（AMI） after percutaneous coronary intervention （PCJ）. Methods Sixty patients with AMI were randomly divided into three groups： adenosine group, nitro glycerin group, and matched control group. After successful PCI in all patients, the three groups were immediately given adenosine （240 μg）, nitro glycerin （200 μg）, normal saline （10 ml）, respectively, by intracomnary injection. Serum levels of yon Wille-brand factor （vWF） and nitric oxide （NO） in patients＇ coronary artery blood were measured before and 30 min after PCI, and coronary flow was assessed by the method of frame counting at the moment of coronary artery recanalization and 5 min after injecting medicine. Results vWF contents after PCI were all higher than before PCI in the three groups（ P 〈 0.05）. vWF contents in the adenosine group and nitro glycerin group were lower than that in the matched control group after PCI（ P 〈 0.05）. NO densities after PCI were lower than before PCI in all groups （ P 〈 0.05） ;they were higher in the adenosine and the nitro glycerin groups than in the matched control group after PCI（ P 〈 0.05）. Frame countings of coronary flow in the adenosine and nitro glycerin groups decreased at 5 min after vascular recanalization, compared with the matched control group（ P 〈 0.05）.Conclusions Adenosine,like nitroglpcerin,reduces plasma vWF content increases NO density,and decreases frame countings of blood flow in coronary artery after PCI, suggesting that adenosine has protective effect on VEC in patients with AMI.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗术 血管内皮 腺苷 

分 类 号：R541.4[医药卫生—心血管疾病]