替米沙坦对冠状动脉慢血流患者氧化应激和血管内皮功能的影响  

Effects of telmisartan on oxidative stress and vascular endothelial function in patients with coronary slow flow

作　　者：伊忻 国伟[2] 刘力文[2] YI Xin GUO Wei LIU Liwen(Department of Laboratory, fining First People＇s Hospital, Jining 272011, China)

机构地区：[1]山东省济宁市第一人民医院医学检验科,272011 [2]山东省济宁市第一人民医院老年医学科,272011

出　　处：《疑难病杂志》2017年第5期441-444,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：济宁市医药卫生科技发展计划项目(2015-57-109)

摘　　要：目的观察替米沙坦对冠状动脉慢血流(CSF)患者氧化应激和血管内皮功能的影响。方法选取2015年8月—2016年8月山东省济宁市第一人民医院心血管诊疗中心因胸痛行冠状动脉造影检查确诊CSF患者126例作为研究对象,随机分为对照组和观察组,每组63例。对照组给予拜阿司匹林、硝酸酯类、阿托伐他汀等常规治疗;观察组在常规治疗的基础上加用替米沙坦治疗。观察治疗前、治疗8周2组间及组内患者冠状动脉血流TIMI计帧、丙二醛(MDA)、活性氧(ROS)、超氧物歧化酶(SOD)及肱动脉血流介导内皮依赖性舒张功能(FMD)、血浆内皮素-1(ET-1)、一氧化氮(NO)水平的变化。结果观察组心绞痛症状改善总有效率为92.06%高于对照组的61.90%(P<0.01)。观察组治疗后SOD、FMD、NO均显著高于治疗前(t=5.631、5.922、5.691,P<0.01);TIMI计帧、MDA、ROS、ET-1水平均低于治疗前(t=7.384、6.462、7.281、6.970,P<0.01)。治疗后对照组TIMI计帧、SOD、MDA、ROS、FMD、NO、ET-1水平与治疗前相比差异均无统计学意义(t=0.471、0.722、0.350、0.193、0.873、0.554、0.381,P>0.05)。治疗后观察组SOD、FMD、NO均较对照组升高(t=4.064、5.091、4.270,P<0.01),且TIMI计帧、MDA、ROS、ET-1水平较对照组降低(t=6.932、4.181、4.360、7.944,P<0.01)。结论替米沙坦治疗CSF优于对照组,替米沙坦可能通过抑制机体氧化应激反应、改善血管内皮功能的机制发挥作用。Objective To investigate the effects of telmisartan on oxidative stress and vascular endothelial function in patients with coronary slow flow（CSF）.Methods One hundred and twenty six patients with CSF and normal coronary angiography were selected.All the patients were randomly divided into conventional treatment group and telmisartan group,63 cases in each group.Patients in conventional treatment group were given conventional treatment（aspirin,nitrates and atorvastatin）,while patients in the telmisartan group were given telmisartan on the basis of conventional treatment.TIMI,malondialdehyde（MDA）;reactrve oxygen species（ROS）;superoxide dismutase（SOD）.endothelial dependent flow mediated vasodilation（FMD）,endothelin 1（ET-1）,nitric oxide（NO） were observed in the two groups before and after eight weeks of treatment.Results TIMI reduced significantly in the telmisartan group after treatment compared with before treatment and conventional group after treatment（t =7.384,t =6.932,P =0.001,P =0.004）.SOD,FMD,NO improved in the telmisartan group after treatment compared with before treatment（t = 5.631,t =5.922,t = 5.691,P =0.00,P =0.000,P =0.002）,MDA,ROS,ET llevel decreased（t =6.462,t =7.281,t =6.970,P =0.001,P =0.004,P =0.005）.TIMI,SOD,MDA,ROS,FMD,NO,ET-1 of conventional treatment had no significantly changes before and after treatment（t =0.471,t = 0.722,t =0.350,t =0.193,t =0.873,t =0.554,t =0.381,P =0.530,P =0.568,P =0.466,P =0.357,P =0.580,P =0.457,P =0.371）.The post treatment of SOD,FMD,NO in telmisartan group were significantly increased with conventional group（t =4.064,t =5.091,t =4.270,P =0.000,P =0.017,P =0.007）,TIMI,MDA,ROS,ET-1 levels in telmisartan group were significantly reduced with conventional group（t =6.932,t =4.181,t=4.360,1=7.944,P-0.004,P =0.002,P =0.007,P =0003）.Conclusion The telmisartan group curative effect is significantly better than that of conventional group in the treatment of CSF,telmisartan may play a role in the mechanism of inhibition of

关 键 词：冠状动脉慢血流 替米沙坦 氧化应激 内皮依赖性舒张功能 

分 类 号：R54[医药卫生—心血管疾病]