法舒地尔治疗冠状动脉慢血流的疗效及对氧化应激的影响  

Curative effect of fasudil in treatment of coronary slow flow and its effects on oxidative stress

作　　者：国伟[1] 刘力文[1] 吴苏宁[1] 张亚男[1] 王盟[2] 伊忻 

机构地区：[1]济宁市第一人民医院老年医学科,山东济宁272011 [2]济宁市第一人民医院药学部,山东济宁272011 [3]济宁市第一人民医院医学检验科,山东济宁272011

出　　处：《心脏杂志》2017年第4期435-438,共4页Chinese Heart Journal

基　　金：济宁市医药卫生科技发展计划项目资助(2015-57-109)

摘　　要：目的探讨盐酸法舒地尔对冠状动脉慢血流(coronary slow flow,CSF)患者的治疗作用及对血浆中机体氧化应激指标丙二醛(MDA)、晚期糖基化终产物(AGEs)、超氧物歧化酶(SOD)、谷胱甘肽转移酶(GST)水平的影响。方法选择因胸痛住院行冠状动脉造影检查显示结果正常但存在着CSF现象的患者82例,随机分为法舒地尔组与常规治疗组,每组患者均为41例。常规治疗组给予拜阿司匹林、阿托伐他汀、硝酸酯类等常规治疗;法舒地尔组在常规治疗基础上给予盐酸法舒地尔治疗。观察治疗前、后2周两组患者心绞痛疗效、冠状动脉血流速度TIMI计帧以及血浆MDA、AGEs、SOD和GST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88%,常规治疗组为66%,差异有统计学意义(P<0.05)。法舒地尔组治疗后患者冠状动脉血流TIMI计帧显著低于治疗前及常规治疗组治疗后(均P<0.01)。两组治疗前MDA、AGEs、SOD、GST水平的比较差异均无统计学意义。法舒地尔组与常规治疗组治疗后血浆MDA、AGEs水平均显著低于本组治疗前(均P<0.01)。法舒地尔组与常规治疗组治疗后血浆SOD、GST水平均显著高于本组治疗前(均P<0.01)。法舒地尔组治疗后血浆MDA、AGEs水平均较常规治疗组治疗后显著下降(均P<0.01)。法舒地尔组治疗后血浆SOD、GST水平均较常规治疗组治疗后显著升高(均P<0.01)。结论法舒地尔治疗CSF的疗效优于常规治疗组,法舒地尔可能通过抑制机体氧化应激反应的机制发挥作用。AIM To investigate the efficacy of fasudil in the treatment of coronary slow flow （CSF） and its effect on plasma oxidative stress indexes： MDA, AGEs, SOD and GST. METHODS Eighty-two CSF patients with normal coronary angiography were randomly divided into conventional treatment group and fasudil group, 41 cases ineach group. Another 40 patients with normal coronary angiography served as control group. Patients in the conventional treatment group were given conventional treatment （ aspirin, nitrates and simvastatin）, while patients in the fasudil group were given fasudil on the basis of the conventional treatment. Angina pectoris, TIMI and levels of plasma MDA, AGEs, SOD and GST of the brachial artery were observed in the three groups before and two weeks after treatment. RESULTS The total effective rate in the fasudil group was higher than that in the control group （88% vs. 66%, P 〈 0. 05）. TIMI improved significantly in the fasudil rout after treatment comoared with that before treRt-ment and with that in the conventional group after treatment （P 〈0. 01 ）. The peripheral blood levels of MDA and AGEs in the CSF group at the beginning of treatment were significantly higher than those in the normal control group （ P 〈 0. 01 ）. The peripheral blood levels of SOD and GST in CSF group at the beginning of treatment were significantly reduced compared with those in the normal control group （P 〈 0.01 ）. The peripheral blood levels of MDA and AGEs in the fasudil treatment group and conventional therapy group were all significantly reduced compared with those in the normal control group （P 〈 0. 01 ）. The peripheral blood levels of SOD and GST in the fasudil treatment group and conventional therapy group were all significantly higher than those in the normal control group （ P 〈 0. 01 ）. No difference in pre-treatment MDA, AGEs, SOD and GST were found between the two groups （ P 〉 0.05 ）. The pre-treatment MDA and AGEs levels in fasudil treatment group were significantly redu

关 键 词：冠状动脉慢血流 盐酸法舒地尓 氧化应激 丙二醛 晚期糖基化终产物 超氧物歧化酶 谷胱甘肽转移酶 

分 类 号：R541.4[医药卫生—心血管疾病]