尼可地爾對(duì)冠脈慢血流患者肱動(dòng)脈血流介導(dǎo)的內(nèi)皮依賴性血管舒張功能影響

[摘要] 目的 探討尼可地爾對(duì)冠狀動(dòng)脈慢血流（CSF）患者肱動(dòng)脈血流介導(dǎo)的內(nèi)皮依賴性血管舒張功能（FMD）影響。方法 經(jīng)冠脈造影診斷為CSF患者120例，根據(jù)治療方法分為對(duì)照組（n=60）與尼可地爾組（n=60）。對(duì)照組給予常規(guī)治療，尼可地爾組給予常規(guī)治療加尼可地爾治療。于治療前、治療后3個(gè)月分別檢測(cè)FMD、APN、hsCRP的水平。 結(jié)果 尼可地爾組患者的FMD較治療前明顯改善（P<0.05），APN較治療前升高（P<0.05），hsCRP較治療前降低（P<0.05），且ΔFMD與ΔAPN呈正相關(guān)、與ΔhsCRP呈負(fù)相關(guān)。常規(guī)治療組的FMD、APN、hsCRP治療前后差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。 結(jié)論 尼可地爾能顯著增加CSF患者FMD，改善內(nèi)皮功能。

[關(guān)鍵詞] 冠脈慢血流；尼可地爾；內(nèi)皮依賴性血管舒張功能

[中圖分類(lèi)號(hào)] R543.3 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 2095-0616（2013）13-12-02

Effects of nicorandil on endothelial-dependent flow-mediated vasodilation of the brachial artery in patients with coronary slow flow

WANG Tao1 LI Yuan2 XIAO Wenliang1 JIANG Zhian1 ZHANG Xiaoguang1 YIN Hongshan1 ZHAO Shujian1 ZHOU Chunxia1 ZHANG Song3

1.Department of Cardiology，Third Hospital of Heibei Medical University，Hebei 050051，China； 2.Department of Medicine，F(xiàn)orth Hospital of Shijiazhuang，Shijiazhuang 050051，China；3.Department of Clinical Laboratory，Third Hospital of Heibei Medical University， Shijiazhuang 050051，China

[Abstract] Objective To investigate the effect of nicorandil on endothelial-dependent flow-mediated vasodilation（FMD） of the brachial artery in patients with coronary slow flow（CSF）. Methods 120 patients with CSF were enrolled and randomized divided into control group（n=60）and nicorandil group（n=60）. Control group patients were administrated of conventional treatment，nicorandil group were administrated of nicorandil on the basis of conventional treatment. The levels of FMD，APN，hsCRP were measured before and three months after treatmeat. Results Compared with before treatment，F(xiàn)MD improved in nicorandil groups after treatment（P<0.05），APN level increased（P<0.05） whereas hs-CRP level decreased（P<0.05）；changes of FMD was positively correlated with changes of APN，and was negativly correlated with changes of hs-CRP. FMD，APN and hs-CRP in control group had no significantly changes after 3 months' treatment. Conclusion Nicorandil can improve the FMD of the brachial artery in patients with CSF.

[Key words] Coronary slow flow；Nicorandil；FMD

冠狀動(dòng)脈慢血流（CSF）是指排除冠狀動(dòng)脈痙攣、血栓、冠狀動(dòng)脈擴(kuò)張等因素，冠脈造影（CAG）沒(méi)有發(fā)現(xiàn)明顯病變，但冠脈血流減慢的現(xiàn)象[1]。其發(fā)病機(jī)制不明確，亦缺乏有效的治療方法。本研究通過(guò)檢測(cè)治療前后CSF患者肱動(dòng)脈血流介導(dǎo)的內(nèi)皮依賴性血管舒張功能（FMD）、血漿hs-CRP及脂聯(lián)素（APN）水平，觀察尼可地爾對(duì)CSF治療效果。

1 對(duì)象與方法

1.1 研究對(duì)象

2011年4月～2013年4月于我院心內(nèi)科因心絞痛行CAG并診斷為CSF的患者120例，隨機(jī)分為兩組，尼可地爾組60例，男39例，女21例，年齡（53.14±9.10）歲；對(duì)照組60例，男36例，女24例，年齡（52.20±10.34）歲，入選患者

均排除冠狀動(dòng)脈異常擴(kuò)張、冠狀動(dòng)脈夾層、肝腎功能不全、心衰。對(duì)照組給予常規(guī)冠心病藥物治療（硝酸酯類(lèi)、阿司匹林、他汀類(lèi)等），尼可地爾組在常規(guī)治療基礎(chǔ)上加服尼可地爾（5 mg，3次/d），隨訪時(shí)間為3個(gè)月。

1.2 研究方法

1.2.1 CSF診斷 CAG結(jié)果由2位有經(jīng)驗(yàn)介入醫(yī)師獨(dú)立分析確定?！?br>