脂质体携载前腺素E1 对不稳定性心绞痛.docVIP

中华综合医学 2002年 第3卷 第7期 China Synthesis Medicine 脂质体携载前腺素E1 对不稳定性心绞痛 患者内皮细胞的保护作用及临床效果 康建强 何梅英 昌 菁 王一尘 上海第二医科大学附属新华医院老年科 200092 摘要 目的 观察脂质体携载前列腺素E1（Lipo—PGE1，凯时注射液），对不稳定性心绞痛（UPA）患者的临床疗效及其对血浆内皮素—1（ET1）和一氧化氮（NO）水平的影响。方法 将60例UPA患者随机分为2组，治疗组（31例）加用凯时治疗，对照组（29例）。两组均常规静滴异舒吉20mg+0.9%NS250ml iv gtt。维持4 min，口服阿斯匹林、钙离子拮抗剂，停服ACEI，心绞痛发作时均舌下含硝酸甘油片，症状改善者硝酸酯类用药逐步减量，并记录硝酸酯类药物用量，其它口服药两组相同。疗程均为10d。观察两组病人心绞痛发作情况，用药前、后各抽静脉血测定ET、NO水平，记录静息心电图变化。结果 治疗组与对照组在住院10d内治疗总有效率分别为90.3%与68.6%（p0.01），p0.01），升高血浆NO水平（p0.01）更显著，2组均未出现明显不良反应。结论 在常规治疗基础上加用凯时治疗UAP能更有效地控制心绞痛发作，明显降低UAP血浆ET水平，显著升高血浆NO水平，因而可以拮抗ET的血管效应，对UAP的治疗产生良好的效果。 关键词 不稳定性心绞痛 脂质体 前列腺素E1 一氧化氮 内皮素 Effect of Lipo-Prostaglandin E1 Injection on Plasma ET1 And NO Levels in Patients with Unstable Angina Pectoris KANG Jian-qiang, HE Mei-ying, CHANG jing, WANG Yi-chen Xinhua Hospital, Shanghai Second Medical University (200092) ABSTRACT Objective In order to evaluate the clinical effect of Lipo-prostaglandin E1(Lipo-PGE1)injection and its effects on plasma ET1 and NO level in patients with unstable angina pectoris (UAP).Methods A total of 60 patients with UAP were randomly as-signed to Lipo-PGE1 group(31 cases)or contrast groups(29cases)for planned follow-up of 10 days. Patients of the Lipo-PGE1 group were administered with Lipo-Prostaglandin E1 injection 10μg/d,i.v. ×10d.Routinely,both of the two groups were treated by Aspirin、Calcium antagonists、Isoket 20mg+NS250ml/i.v.gtt qd×10d,which lasting at least 4 hours stopping At the same time when UAP happened, all the patients were administered with Nitroglycerin infralingual and reduced the dosage of nitrate when symptoms remission. Also, the other drugs taken orally were the same in both groups.ET1 and NO level in plasma were estimated before and after treatment, symptoms and EKG of the patients were recorded at the same time. Results The total efficacy rate in the Lipo-PGE1 group, which were higher than those of the contrast group, respectively 90