培哚普利在冠心病经皮冠状动脉介入术后的应用效果及其对神经激素水平、内皮功能的影响

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摘要目的观察培哚普利在冠心病经皮冠状动脉介入术后的应用效果，并分析其对神经激素水平、内皮功能的影响。方法选取2013年12月~2017年12月湖南中医药大学第一附属医院行经皮冠状动脉介入治疗的120例患者作为研究对象。按治疗方案的不同分为对照组（60例）和观察组（60例）。对照组根据病情给予常规基础治疗且接受经皮冠状动脉介入术，观察组在对照组的基础上，给予培哚普利片口服治疗，疗程为3个月。比较两组治疗前后神经激素、内皮和心功能相关指标，并记录两组术后1年缺血事件发生情况。结果治疗前，两组血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）和心钠素（ANP）水平比较，差异无统计学意义（P > 0.05）。治疗后，两组AngⅡ、ALD和ANP水平低于治疗前，且观察组低于对照组，差异均有统计学意义（均P < 0.05）。治疗前，两组内皮祖细胞（EPCs）、一氧化氮（NO）和内皮素-1（ET-1）水平比较，差异无统计学意义（P > 0.05）。治疗后，两组EPCs和NO水平高于治疗前，ET-1水平低于治疗前，且观察组EPCs和NO水平高于对照组，ET-1水平低于对照组，差异均有统计学意义（均P < 0.05）。治疗前，两组左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）和左室射血分数（LVEF）水平比较，差异无统计学意义（P > 0.05）。治疗后，两组LVEDV和LVESV水平低于治疗前，LVEF水平高于治疗前，且观察组两组LVEDV和LVESV水平低于对照组，LVEF水平高于对照组，差异均有统计学意义（均P < 0.05）。观察组术后1年缺血事件发生率显著低于对照组，差异有统计学意义（P < 0.05）。结论培哚普利可有效改善冠心病患者经皮冠状动脉介入术后的神经激素水平和内皮损伤状况，并改善心脏泵血功能，降低术后临床缺血事件的发生。

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	周小明1 邓桂明2 谭琦1▲

关键词 ：培哚普利, 冠心病, 经皮冠状动脉介入术, 神经激素水平, 内皮功能

Abstract：Objective To observe the application effect of Perindopril in patients with coronary heart disease after percutaneous coronary interventions, and analyze its influence on neurohormone and endothelial function. Method From December 2013 to December 2017, 120 cases with coronary heart disease who underwent percutaneous coronary interventions in the First Hospital of Hu′nan University of Chinese Medicine were selected. They were divided into the control group (60 cases) and the observation group (60 cases), according to different treatment regimens. The control group was received routine basic treatment and percutaneous coronary intervention according to their condition, and the observation group was received Perindopril Tablets orally on the basis of treatment in the control group. The course of treatment was 3 months. The neurohormone, endothelial function and cardiac function indexes before and after treatment of the two groups were compared and the incidence of ischemic events 1 year after operation was recorded in both groups. Results Before treatment, there was no statistically significant difference in angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and atrial natriuretic peptide (ANP) level of the two groups (P > 0.05). After treatment, Ang Ⅱ, ALD and ANP levels of the two groups were lower than those before treatment, and the observation group was lower than the control group, and the differences were statistically significant (all P < 0.05). Before treatment, there was no significant difference in the endothelial progenitor cells (EPCs), nitric oxide (NO) and endothelin-1 (ET-1) level between the two groups (P > 0.05). After treatment, the EPCs and NO levels in the two groups were higher than those before treatment, and the levels of ET-1 were lower than before treatment, and the EPCs and NO levels in the observation group were higher than those in the control group, the levels of ET-1 were lower than those in the control group, with statistically significant differences (all P < 0.05). Before treatment, there was no statistically significant difference in left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) level between the two groups (P > 0.05). After treatment, LVEDV and LVESV levels in the two groups were lower than those before treatment, and LVEF levels were higher than those before treatment. LVEDV and LVESV levels in the observation groups were lower than those in the control group, and LVEF levels were higher than those in the control group, with statistically significant differences (all P < 0.05). The incidence of ischemic events 1 year after operation in the observation group was significantly lower than that in the control group, with statistically significant differences (P < 0.05). Conclusion Perindopril can effectively improve the level of neurohormone and endothelial injury after percutaneous coronary intervention in patients with coronary heart disease, improve the pumping function of the heart, and reduce the occurrence of postoperative clinical ischemic events.

Key words： Perindopril Coronary heart disease Percutaneous coronary interventions Neurohormone Endothelial function

基金资助:湖南省自然科学基金项目（2018JJ6040）；
中医内科重大疾病防治研究与转化教育部重点实验室开放课题项目（2YNK201702）。

通讯作者: ▲通讯作者

引用本文:

周小明1 邓桂明2 谭琦1▲. 培哚普利在冠心病经皮冠状动脉介入术后的应用效果及其对神经激素水平、内皮功能的影响[J]. 中国医药导报, 2020, 17(11): 48-52.
ZHOU Xiaoming1 DENG Guiming2 TAN Qi1▲. The application effect of Perindopril in patients with coronary heart disease after percutaneous coronary interventions and its influence on neurohormone and endothelial function. 中国医药导报, 2020, 17(11): 48-52.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I11/48

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