宽胸气雾剂缓解冠心病心绞痛发作及对血管内皮功能的影响

The Relieving Effects of Kuanxiong Aerosol on Angina Pectoris and Its Influences on Endothelial Function Index in Patients with Coronary Heart Disease

目的观察宽胸气雾剂对冠心病患者心绞痛速效缓解疗效及安全性。方法将患者75例按随机数字表法分为治疗组39例(予宽胸气雾剂)和对照组37例(予硝酸甘油气雾剂),于心绞痛发作前后分别行电脑多导联心电图检查,记录心绞痛发作的程度、喷服次数和起效时间及副作用等,喷服3 d后取血观察患者血中内皮素(ET-1),一氧化氮(NO)及环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP)等的变化。结果治疗组心绞痛缓解总有效率、心电图疗效总有效率与对照组比较差别不大(P>0.05)。两组治疗后与治疗前比较,血中ET-1水平下降,NO含量、cGMP升高(均P<0.01),而cAMP变化不大,两组比较亦差别不大(均P>0.05)。两组用药期间未出现血、尿、便常规异常,肝、肾功能等前后检测也未发现异常。结论宽胸气雾剂能有效缓解冠心病心绞痛的发作,与硝酸甘油气雾剂疗效相当,其缓解心绞痛发作机制与一氧化氮—环磷酸鸟苷通路有关。

Objective： To observe the rapid alleviating efficacy and safety of Kuanxiong Aerosol on angina pec- toris in patients with coronary heart disease（CHD）. Methods： A total of 75 CHD patients were randomly divided into the aerosol group and the nitroglycerin aerosol group. At the time of enrollment, heart attack occurrence and after alleviation, computer analysis electrocardiogram were performed respectively. The severity of heart attacks, spray times, onset time and side effects were recorded. After three days of aerosol using, blood samples were taken for detecting the changes of endothelin-l,nitric oxide,cAMP and cGMP. Results： Compared with nitroglycerin aerosol,Kuanxiong Aerosol had a quick effect on relieving the chest pain attack in CHD patients,and in the onset time and the total effective rate of easing chest pain of heart attacks ,there was no statistical difference between the two group （P〉 0.05）. The total effective rate of electrocardiogram improvement in Kuanxiong Aerosol group and nitroglycerin aerosol group was 81.25% and 90.32% respectively,and there was no statistical difference （P〈 0.05）. The vascular endothelial function tests showed that Kuanxiong Aerosol could reduce the endothelia level, improve the content of nitric oxide, and increase the serum cyclic guanosine monophosphate level. There was little difference in the total effective rate of angina pectoris and ECG between the treatment group and the control group （P〉 0.05）. Compared with pre-treatment,the level of ET-1 dropped and NO and cGMP rose（P〈 0.01 ）,but there was little change in cAMP between the two group（P〉 0.05）. During medication period,there were no blood,urine and stool abnormal, and no abnormal fluctuations in liver, kidney and other function test. Conclusion： Compara- ble with nitroglycerin aerosol,Kuanxiong Aerosol has effects on fairly relieving the chest pain attack in CHD pa- tients. The mechanism of angina alleviation in equivalence is the pathway between NO and cGMP.