前列腺素E_1对微血管性心绞痛的疗效观察及其机制的探讨

The effect and mechanism of prostaglandin E_1 on microvascular angina

目的:观察脂微球技术的前列腺素E_1对微血管性心绞痛的治疗作用,并对其机制进行初步探讨。方法:110例微血管性心绞痛患者随机分为试验组和对照组,记录基线资料,测量血内皮素1(ET-1)和一氧化氮(NO)的浓度。2组均予以常规抗心绞痛治疗,试验组加用前列腺素E_1治疗1周。1个月后复查运动平板试验及血中ET-1、NO的浓度。结果:2组间基线资料无明显差异,1个月后试验组和对照组最大运动能力及ST段下移水平均较基线有明显改善(P<0.05)。1个月后试验组心绞痛发生率及ST段下移水平较对照组有明显降低(P<0.05),最大运动能力较对照组明显升高(P<0.05),伴有ET-1水平下降(P<0.05),NO水平升高(P<0.05)。结论:前列腺素E_1能够改善微血管性心绞痛患者症状,提高运动能力,此作用可能是通过改善内皮功能实现的。

Objective To evaluate the effect of lipid microsphere prostaglandin E1 on microvascular angina and in- vestigate its mechanism. Methods A total of 110 patients with microvascular angina were randomly divided into experi- ment group and control group. The baseline clinical features, serum endothelin-1 （ET-1） and nitric oxide （NO） levels were recorded. Both groups were treated with routine medication for angina, while the experiment group with the addition of prostaglandin El. One month later, all the patients had the treadmill exercise test, serum ET-1 and NO levels re-checked. Results There was no significant difference in baseline characteristics between the two groups. One month later, the max- imal exercise capacity and depression of ST segment were improved in both groups when compared with the baseline val- ue（P〈0.05）. The incidence of angina and depression of ST segment in experiment group were lower than that in control group, and the maximal exercise capacity was better than that in control group （P〈0.05）. Level of ET-1 was lower and level of NO was higher in experiment group than that in control group （P〈0.05）. Conclusions Prostaglandin El can ame- liorate the symptom of microvascular angina and improve the exercise capacity, probably by improving the endothelial function.