冠状动脉慢血流患者一氧化氮和内皮素1浓度的变化

目的探讨冠状动脉慢血流(coronary slow flow,CSF)患者的血管内皮功能。方法选择因胸痛行冠状动脉造影的患者40例,根据造影结果分为CSF组20例和对照组20例。2组分别于静息和多巴酚丁胺负荷试验结束时立即抽取血标本,检测血浆内皮素1、血清NO浓度,并进行比较。结果 CSF组静息时血浆内皮素1浓度较对照组升高,但差异无统计学意义(P>0.05),而药物负荷试验后血浆内皮素1浓度较对照组明显升高,差异有统计学意义[(37.60±6.93)ng/L vs(14.16±5.73)ng/L,P<0.01]。CSF组静息时和药物负荷试验后血清NO浓度均明显低于对照组,差异有统计学意义[(42.36±9.72)μmol/L vs(50.39±9.77)μmol/L,(24.88±9.28)μmol/L vs(61.06±8.20)μmol/L,P<0.01)]。结论 CSF患者无论静息或者药物负荷状态下均存在内皮素1及NO平衡失调,负荷状态下这种平衡失调现象更加明显。

Levels of nitric oxide and endothelin-1 in patients with coronary slow flow

Objective To study the vascular endothelial function in patients with coronary slow flow(CSF).Methods Forty patients who underwent coronary artery angiography due to chest pain were divided into CSF group(n = 20) and control group(n= 20) according to their coronary artery angiography findings.Blood samples were taken at rest and immediately at the end of dobutamine laoding test.Plasma endothelin-1 and serum nitric oxide(NO) levels were measured in the two groups.Results Although the plasma endothelin-1 level was higher in CSF group than in control group,no significant difference was noted between the two groups at rest(P>0.05). However,it was significantly higher in CSF group than in control group after dobutamine loading test(37.60±6.93 ng/L vs 14.16±5.73 ng/L,P<0.01).The serum NO level was significantly lower in CSF group than in control group at rest and after dobutamine loading test(42.36±9.72μmol/L vs 50.39±9.77μmol/L,24.88±9.28μmol/L vs 61.06±8.20μmol/L,P<0.01).Conclusion The plasma endothelin-1 and serum NO levels are imbalanced in CSF patients both at rest and after dobutamine loading test,especially after dobutamine loading test.