顽固性心绞痛患者胸段硬膜外阻滞治疗后一氧化氮和循环内皮细胞变化

观察高位胸段硬膜外阻滞对顽固性心绞痛的治疗效果,将61例顽固性心绞痛患得接受胸段硬膜外阻滞治疗,停用硝酸甘油,观察疗效及心电图变化,并于阻滞前及阻滞后第14天检测血浆一氧化氮、内皮素－1和循环内皮细胞水平。结果发现,胸段硬膜外阻滞后心绞痛缓解率为100％,心电图ST段压低导联数和ST压低值显著减少（P＜0．05）,一氧化氮水平升高而内皮素－1和循环内皮细胞水平下降（P＜0．01）。结果提示,胸段硬膜外阻滞对顽固性心绞痛疗效满意,并可能通过保护血管内皮细胞起作用。

Changes of Plasma Concentration of Nitric Oxide and Circulating Endothelium Cell Levels in Patients with Refractory Angina Pectoris Treated with Thoracic Epidural Anesthesia

Aim To investigate the role of thoracic epidural anesthesia (TEA) and the change of concentration of nitric oxide (NO) and circulating endothelium cell (CEC) in patients with refractory angina pectoris (RAP). Methods 61 patients with RAP were treated with TEA as the main therapy after cessation of nitroglycerin infusion. The clinical effect of TEA was recorded and plasma concentration of NO,endothelin-1 (ET-1) and CEC was investigated before and 14 days after TEA. Results All patients had reduced severity of chest-pain after TEA. The number of leads with ST depression and degree of ST depression decreased significantly after TEA (P<0.05). Plasma concentration of NO increased after the therapy, whereas ET, CEC decreased significantly (P<0.01). Conclusion TEA may be an effective therapeutic approach for patients with refractory angina pectoris, associated with a protective effect for endothelium cells.