前列地尔改善冠心病患者心肌微循环及血液流变学的疗效分析

摘要

Objective To analysis the effect of alprostadil on improving myocardial microcirculatory disturbance and hemorrheology in patients with coronary heart disease (CHD).Methods Selected 164 patients with CHD were divided into two groups, which were control group (receiving therapy based on the indexes) and research group (receiving alprostadil injection 10μg in addition to the therapy of the index), according to the different therapeutic regimen . Each group was 82 cases and the course of treatment was 2 weeks. The levels of serum NO, VEGF and TXβ2 were detected and compared between two groups. And the indexess of hemorrheology were also detected and compared between two groups. The classes of TIMI and TMPG of patients which were received coronary angiography (CAG) were compared between two groups.Results Compared to control group, the levels of serum NO and VEGF in research group were higher, but serum TXβ2 were lower,P<0.05, had difference statistically signiifcance. And the levels of high-shear viscosity, low-shear viscosity, plasma viscosity, fibrinogen, erythrocyte aggregation index, platelet aggregation rate were lower,P<0.05, had difference statistically signiifcance. The classes of TIMI and TMPG in research group were better than the control group,P<0.05, had difference statistically signiifcance.Conclusion The alprostadil can obviously improve the myocardial microcirculatory disturbance and hemorrheology in patients with CHD.%目的：评价应用前列地尔对改善冠心病（CHD）患者心肌微循环功能障碍及血液流变学紊乱的临床疗效。方法选取164例我院就诊的CHD患者，依据给药方案不同分为：对照组给予指南规定用药；研究组在对照组用药基础上予以前列地尔注射液10μg治疗，各82例，治疗疗程均为2 W。检测并比较两组血清NO、VEGF及TXβ2水平的差异；比较两组各血液流变学指标的差异；比较两组患者接受冠脉造影检查（CAG）中的TIMI分级及心肌灌注分级（TMPG）差异。结果与对照组相比，研究组的血清NO、VEGF水平较高，而TXβ2水平较低， P＜0.05，差异具有统计学意义；研究组的全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原、红细胞聚集指数和血小板聚集水平较低，P＜0.05，差异具有统计学意义。接受CAG患者中研究组的TIMI及TMPG分级较对照组改善，P＜0.05，差异具有统计学意义。结论应用前列地尔能改善CHD患者的心肌微循环障碍及血液流变学紊乱程度。