福辛普利治疗对老年冠心病患者冠脉血流储备的影响

Effects of Fosinopril on Coronary Flow Reserve in Elderly Patients with Coronary Heart Disease

目的观察老年冠心病患者中冠状动脉血流储备(CFR)的变化及福辛普利治疗对老年冠心病患者CFR的影响。方法选取27例老年冠心病患者及28例健康老年人作对照组 ,将福辛普利 (5～10mg)治疗前患者的血压、血糖、血脂(serumtotalcholesterol,TC;lowdensitylipidcholesterol,LDL -C;triglyceride,TG)、血清内皮素(ET-1)的浓度以及CFR(应用彩色多普勒超声仪检测 )与对照组进行比较 ,并将治疗前后的各项指标进行比较。结果冠心病患者血压、血糖与TG水平与对照组比较没有显著性差异 (P>0.05) ,而TC及LDL -C水平明显高于对照组(P<0.05及P<0.01) ,福辛普利治疗前后患者的血压、血糖与血脂无明显改变(P>0.05)。冠心病组ET -1水平为(113.5±9.7)pg/ml较对照组(76.2±10.8)pg/ml高(P<0.01) ,福辛普利治疗6月后 ,ET -1浓度下降为(77.5±12.0)pg/ml(P<0.01)。冠心病患者CFR低于对照组(P<0.01) ,福辛普利治疗6月后 ,CFR上升(P<0.01)。结论福辛普利治疗可改善老年冠心病患者的内皮功能 ,并能明显改善患者的CFR。

Objective To investigate the coronary flow reserve(CFR)in elderly patients with coronary heart disease(CHD)and the effects of fosinopril on the CFR in these subjects.Methods27patients with CHD and28healthy elderly subjects were studied.The systolic blood pressure(SBp)and diastolic blood pressure(DBp),the concentration of blood glucose(FBG),blood glucose2hours post breakfast(P2hBG),total cholesterol(TC),low density lipid cholesterol(LDL-C),triglyceride(TG)and serum endothelin-1(ET-1),and the CFR which measured by Color Doppler ultrasonic system in elderly patients with CHD pre-therapy with fosinopril were compared with those in control group.In addition,the corresponding data in CHD group pre-therapy with fosinopril were compared with those post-therapy with fosinopril.Results Blood pressure,blood glucose,and TG had no sigˉnificant difference between control group and CHD group(P>0.05).There was no significant difference between pre-therapy and post-therapy in patients with CHD.The concentration of serum ET-1in elderly CHD was significantˉly higher than that in control group(113.5±9.7pg/ml vs76.2±10.8pg/ml,P<0.01).It lowered to(77.5±12.0)pg/ml(P<0.01)after therapy with fosinopril for half a year.The CFR in CHD patients was lower than that in control group(2.49±0.56vs3.58±0.46,P<0.01).It rose to3.34±0.47(P<0.01)after therapy for6months.Conclusions Therapy with fosinopril could effectively improve the endothelium function and CFR in elderˉly patients with coronary heart disease.