果糖二磷酸钠对冠心病心绞痛的疗效及其脂质过氧化抑制作用

目的 :观察国产果糖二磷酸钠 (FDP)对冠心病心绞痛患者的运动能力及左心功能的影响。方法 :4 2例心绞痛患者入院后经 1～ 2周的症状稳定期后 ,随机分为A组或B组。A组静滴安慰剂 ( 5 %葡萄糖溶液 10 0ml)bid× 10d ;继静滴FDP 10 gbid× 10d ;B组治疗与A组相同而顺序相反。患者分别在安慰剂和FDP治疗前和治疗的最后 2d行ECG平板运动负荷试验和放射性核素门电路平衡法心血池造影 ;并在用药前和用药的最后 1d清晨 ,分别取静脉血测丙二醛 (MDA)含量和红细胞超氧化物歧化酶 (SOD)活性。结果 :对心绞痛患者 ,FDP能延长运动持续时间 ,运动起始至心绞痛发作时间 ,运动起始至ST段下降1mm时间及运动起始至达到最大ST段下降时间 ;提高患者所耐受的最大运动负荷和运动起始至ST段下降 1mm负荷 ,增加左室射血分数 (LVEF)和高峰充盈率 (PFR) ,对静息及运动HR和BP均无显著作用。FDP能减少冠心病患者血浆脂质过氧化丙二醛 (MDA)的产生 ,而对红细胞SOD活性无明显影响。结论 :FDP静滴后可在一定程度上改善稳定型心绞痛患者的运动能力及左心室功能。对冠心病患者具有抑制脂过氧化的作用 ,此作用可能是其对缺血缺氧心缺的保护机制之一。

The Inhibition of Lipid Peroxidation by the Effects of Fruc tose-1,6-Diphosphate in Patients with Stable Angina Pectoris

Objective: The effects of FDP were evaluated in 42 patients with stable angina pectoris using a double blind, placebo-contro lled, crossover trial design. Methods: After their angina was stabilized, the 42 patients were randomly assigned to sequence group A or B. Group A received a placebo intraven ously (iv gtt) 2 times daily for 10 days and then FDP 10g iv gtt 2 times daily f or 10 days. Group B received the same treatment in the reverse order. Treadmill exercise test and radionuclear angiography were performed before and in the last two days of placebo or FDP treatment. Blood samples were taken before the treatment and after last dose to monitor plasma malonaldehyde and ery throcyte SOD activity. Results: FDP prolonged exercise duration, time to angina pectori s and time to ST segment depression exceeding 1mm, increased maximum exercise bu rden. FDP also improved left ventricular ejection fraction and peak filling rate . Malonaldehyde production was reduced but no changes in the activity of erythro cyte SOD after the FDP infusion. Conclusion: FDP is beneficial to patients with stable angina p ectoris. It can prolong exercise duration, and improves left ventricular function. Exogenous FDP may inhibit lipid peroxidation in CAD patients, which may be one of the mechanisms of its protection from myocardial ischemia.