摘要
目的:观察脂质体携载前列腺素E_1(Lipo-PGE_1)对不稳定性心绞痛(UA)的治疗作用并探讨其可能的作用机制。方法:随机将87例入选的UA患者分为Lipo-PGE_1治疗组(A组,41例)和安慰剂对照组(B组,46例)。在常规抗心绞痛治疗基础上A组加用Lipo-PGE_1 40μg,每日一次静滴,连用7d,B组则给予等容量的脂肪乳剂(Lipo-PGE_1溶剂)。观察1周内心绞痛发作次数及硝酸甘油服用量,评价动态心电图(DCG)及运动试验(ET)致心肌缺血的客观指标,并测定治疗前后血小板最大聚集率(PAGT_(max)),血浆α颗粒膜蛋白140(GMP-140)及P-选择素水平。随访1个月。结果:治疗期7d内,平均胸痛发作次数及硝酸甘油服用量A组明服低于B组;DCG及ET显示的心肌缺血客观指标A组较B组显著改善。治疗后PAGT_(max)及血浆GMP-140和P-选择素水平A组均显著低于B组。随访30d内两组心血管事件发生率无显著性差异,但A组病人较少复发心绞痛。结论:Lipo-PGE_1 40 μg每日iv一次,结合常规的抗心绞痛措施治疗UA,能明显减少心绞痛发作,改善心肌缺血客观指标。抗炎、抗血小板特性可能是其抗心肌缺血的机制。
OBJECTIVE: To evaluate the effectiveness of liposomal prostaglandin E1 (Lipo-PGE1) in patients with unstable angina (UA) and discuss it's mechanism. METHODS: A prospective, single-blind, placebo-controlled randomized clinical trial was conducted. Eighty-seven patients with UA were randomly assigned to two treatment groups: group A (41 patients) received Lipo-PGE1(40μg, intravenous infusion, once a day for 7 days ) and group B(46 patients) received placebo (the same volume of liposome diluent), in addition to common antianginal therapy. Variables evaluated were number of anginal events and intake dosage of nitrate for one week, data from Holier monitoring electrocardiogram and pre-discharge exercise test ( ET ). Platelet activation and inflammation degree were detected by platelet aggregation, plasma alphagranule membrane protein 140(GMP-140) and P-selectin. All patients were followed-up for 30 days after admitted to the hospital. RESULTS: After one week of treatment, anginal symptoms(events/week) and intake of nitrates (capsules/week) were reduced significantly in group A compared with in group B. Objective variables of myocardial ischemia were improved significantly in group A than in group B. Platelet aggregation and plasma levels of both GMP-140 and P-selectin were reduced markedly in group A than in group B. Within a follow-up of 30 days, group A patients had a lower incidence of recurrent angina, although the incidence of cardiovascular events in two groups were similar. CONCLUSIONS: The combination of Lipo-PGE1(40μg,once a day for 7 days) and common antianginal therapy represents an effective anti-ischemic and antianginal approach for patients with severe unstable angina .Anti-platelet and anti-inflammation properties may be anti-ischemic mechanisms.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2003年第2期87-91,共5页
The Chinese Journal of Clinical Pharmacology
