盐酸法舒地尔对PCI术后慢血流冠心病患者内皮细胞损伤的作用及其机制研究  

Protective effects of fasudil hydrochloride on endothelial cell injury in coronary heart disease with slow blood flowpatients undergo CPI

作　　者：杨雪佳[1] 胡靖[2] 张媛媛[3] 刘艳静 董秋立[1] 李明芳 Xue-jia Yang;Jing Hu;Yuan-yuan Zhang;Yan-jing Liu;Qiu-li Dong;Ming-fang Li(The Second Department of Cardiovascular Disease,North China Petroleum Administration General Hospital,Renqiu,Hebei 062552,China;Department of Nursing,North China Petroleum Administration General Hospital,Renqiu,Hebei 062552,China;Old Age Ward,North China Petroleum Administration General Hospital,Renqiu,Hebei 062552,China)

机构地区：[1]华北石油管理局总医院心血管二病区,河北任丘062552 [2]华北石油管理局总医院护理部,河北任丘062552 [3]华北石油管理局总医院老年病区,河北任丘062552

出　　处：《中国现代医学杂志》2020年第13期31-36,共6页China Journal of Modern Medicine

基　　金：河北省卫生健康委医学科学研究课题计划项目(No:20191171)。

摘　　要：目的探讨采用盐酸法舒地尔治疗对减轻经皮冠脉介入术(PCI)后慢血流冠状动脉粥样硬化性心脏病(以下简称冠心病)患者血管内皮细胞损伤的临床价值。方法选取2015年5月-2016年8月华北石油管理局总医院实施PCI治疗慢血流冠心病患者120例作为研究对象。按入院顺序随机分为治疗组和对照组,每组60例。两组患者术后均采用常规治疗,治疗组术后同时给予盐酸法舒地尔治疗,疗程2周。对比两组的血管内皮损伤、内皮舒张及炎症指标。治疗后随访3个月,记录两组患者发生的心血管不良事件。结果治疗前两组患者外周血内皮细胞微粒(EMPs)、血管性假血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮NO、一氧化氮合酶(eNOS)、血管舒张功能(FMD)、血管内皮舒张功能(NMD)、白细胞介素-6(IL-6)、C反应蛋白(CRP)及肿瘤细胞坏死因子-α(TNF-α)比较,差异无统计学意义(P>0.05);治疗后两组患者上述指标比较,差异有统计学意义(P<0.05),治疗组EMPs、vWF、ET-1、IL-6、CRP和TNF-α降低,NO、eNOS、FMD及NMD升高;治疗前后两组比较,治疗后患者外周血EMPs、vWF、ET-1、IL-6、CRP及TNF-α较治疗前降低(P<0.05),NO、eNOS、FMD及NMD较治疗前升高(P<0.05);与对照组比较,治疗组治疗后的心血管不良事件发生降低(P<0.05)。结论冠心病PCI术后采用盐酸法舒地尔治疗能减轻慢血流冠心病患者的炎症反应程度及血管内皮细胞损伤。Objective To investigate the protective effects of fasudil hydrochloride on endothelial cell injury in coronary heart disease with slow blood flow patients who underwent percutaneous coronary intervention(PCI).Methods From May 2015 to August 2016,120 cases coronary heart disease with slow blood flow patients with who underwent PCI were enrolled into our study and randomly divided into 2 groups:60 patients in the treatment group and 60 patients in the control group.All patients were treated with the conventional treatment.The patients in the treatment group were treated with fasudil hydrochloride based on the conventional treatment.Both groups had been treated for 2 weeks.The endothelial cell injury indexes and inflammatory indexes were compared between 2 groups before and after treatment.After 3 months’follow-up,the cardiovascular adverse events occurred in 2 groups were recorded and compared.Results Before treatment,there was no differences in plasma endothelial microparticles(EMPs),vascular von wille brand factor(vWF),endothelin-1(ET-1),nitric oxide(NO),endothelial nitric oxide synthase(eNOS),flow mediated dilation(FMD),nitroglycerin-mediated dilation(NMD),interleukin 6(IL-6),C-reactive protein(CRP)and tumor necrosis factor alpha(TNF-α)between 2 groups(P<0.05).Compared with the control group,the EMPs,vWF,ET-1,IL-6,CRP and TNF-αhad decreased(P<0.05),the NO,eNOS,FMD and NMD had increased(P<0.05)in the treatment group after treatment;the EMPs,vWF,ET-1,IL-6,CRP and TNF-αhad decreased(P<0.05),and the NO,eNOS,FMD and NMD had increased,in both groups(P<0.05);compared with the control group,there had less cardiovascular adverse events in the treatment group(P<0.05).Conclusion Fasudil hydrochloride treatment can reduce the degree of inflammatory response and vascular endothelial cell injuries in patients after PCI.

关 键 词：冠心病 经皮冠状动脉介入术 盐酸法舒地尔 内皮细胞损伤 

分 类 号：R541.4[医药卫生—心血管疾病]