福新普利和依普利酮对冠状动脉介入治疗患者血浆骨桥蛋白表达的影响

Impact of Fuxinpuli and Eplerenone Coronary on Intervention Treatment of Patients with Plasma Osteopontin Expression

目的:观察血管紧张素转换酶抑制剂(ACEI)和/或醛固酮受体拮抗剂对冠心病患者介入治疗(PCI)后血浆骨桥蛋白(OPN)的影响。方法因冠心病接受 PCI治疗的100例患者随机分为常规治疗组、福新普利组(10 mg/d),依普利酮组(10 mg/d),联合用药组(各5 mg/d)。治疗1次/d,持续14d。因冠心病行冠脉造影但无需PCI术患者25例作为对照组。分别于术前、术后3d和术后14d测定血浆OPN浓度。结果各组间介入治疗前血浆OPN表达无显著差异,术后呈时间依赖性升高。给予ACEI及醛固酮受体拮抗剂干预后,术后14d OPN表达水平显著降低,以联合用药组下降最为明显。结论 PCI术后血浆OPN水平升高,而ACEI与醛固酮受体拮抗剂均能降低OPN表达,且联合用药最为明显。 ACEI与醛固酮受体拮抗剂联合应用可降低血浆 OPN表达,抑制血管内皮损伤,防治PCI术后再狭窄。

Objective:This study was to investigate the ef ect of fosinopril and eplerenone on the plasma level of osteopontin(OPN)in coronary artery disease(CAD)patients receiving percutaneous coronary intervention(PCI).Method:A total of 100 patients with coronary artery disease receiving PCI were randomly divided into 4 groups:PCI group,fosinopril(F;10 mg/d)group,eplerenone(E;10 mg/d)group and F+E group(5 mg/d for each)(n=25 per group).Another 25 CAD patients receiving coronary angiography alone were also recruited as controls.The plasma OPN levels were measured preoperatively and 3 and 14 days postoperatively.Results:There was no significant dif erence in preoperative plasma OPN level among al groups.After PCI,the plasma OPN increased with a time-dependent manner.After treatment with fosinopril and/or eplerenone,the postoperative plasma OPN level decreased markedly at 14 days,and the highest reduction was found in the F+E group.Conclusion:PCI may lead to an increase in plasma OPN,and ACEI and/or aldosterone receptor antagonist can decrease the PCI-induced OPN increase.ACEI and/or aldosterone receptor antagonist can exert synergistic ef ect to prevent postoperative restenosis in CAD patients receiving PCI.