中国医药
中國醫藥
중국의약
China Medicine
2015年
12期
1729-1732
,共4页
葛海龙%马晓海%赵蕾%赵迎新%杨丽霞%史冬梅%周玉杰
葛海龍%馬曉海%趙蕾%趙迎新%楊麗霞%史鼕梅%週玉傑
갈해룡%마효해%조뢰%조영신%양려하%사동매%주옥걸
冠状动脉慢血流%通心络胶囊%血流储备功能
冠狀動脈慢血流%通心絡膠囊%血流儲備功能
관상동맥만혈류%통심락효낭%혈류저비공능
Coronary slow flow%Tongxinluo capsule%Coronary flow reserve
目的 采用无创磁共振血流测量技术评估通心络胶囊对冠状动脉结构正常但血流缓慢患者血流储备功能的影响.方法 选择2011年3月至2014年5月在首都医科大学附属北京安贞医院因胸痛症状行冠状动脉造影检查诊断为冠状动脉慢血流(CSF)的患者71例,采用随机数字表法分为对照组(33例)和观察组(38例).对照组给予常规治疗(硝酸酯类、阿司匹林及阿托伐他汀),观察组在对照组基础上口服通心络胶囊3粒/次,3次/d,2组治疗时间均为3个月.对患者行磁共振成像检查,利用流速编码相位对比技术对右冠状动脉和左前降支近段血流进行测量,分别测量2组患者静息状态和双嘧达莫静脉注射后负荷状态下的血流,并计算冠状动脉血流储备功能(CFR).观察治疗前、治疗12周后2组患者冠状动脉血流储备功能的变化.结果 2组患者治疗前冠状动脉血流量差异无统计学意义(P＞0.05);观察组治疗12周后左前降支、右冠状动脉的静息及负荷状态血流量均较本组治疗前明显增加,差异有统计学意义[左前降支静息状态:(1.82±0.33) ml/s比(1.35±0.36) ml/s,负荷状态:(2.81±0.34) ml/s比(1.83±0.32) ml/s;有冠状动脉静息状态:(1.75±0.32) ml/s比(1.67±0.43) ml/s,负荷状态:(3.21±0.25) ml/s比(1.75±0.34) ml/s,P＜0.05];对照组左前降支、右冠状动脉的静息状态下血流量较治疗前增加,差异有统计学意义[(1.65±0.32) ml/s比(1.39±0.35) ml/s,(1.74±0.38) ml/s比(1.37±0.29) ml/s,P＜0.05],负荷状态下血流量差异无统计学意义(P＞0.05),治疗12周后,观察组左前降支、右冠状动脉治疗后的静息及负荷状态下血流量均高于对照组,差异有统计学意义(P＜0.05);观察组治疗12周后左前降支及右冠状动脉的CFR明显高于本组治疗前及对照组治疗后,差异有统计学意义[左前降支:(3.36±0.36) ml/s比(2.29±0.30)、(2.55±0.43) ml/s,右冠状动脉:(3.11±0.26)ml/s比(2.38±0.36)、(2.58±0.31) ml/s,P＜0.05],而对照组左前降支及右冠状动脉的CFR与治疗前比较差异无统计学意义(P＞0.05).结论 通心络胶囊可改善冠状动脉慢血流患者的血流量缓慢状态,增加其冠状动脉血流储备功能.
目的 採用無創磁共振血流測量技術評估通心絡膠囊對冠狀動脈結構正常但血流緩慢患者血流儲備功能的影響.方法 選擇2011年3月至2014年5月在首都醫科大學附屬北京安貞醫院因胸痛癥狀行冠狀動脈造影檢查診斷為冠狀動脈慢血流(CSF)的患者71例,採用隨機數字錶法分為對照組(33例)和觀察組(38例).對照組給予常規治療(硝痠酯類、阿司匹林及阿託伐他汀),觀察組在對照組基礎上口服通心絡膠囊3粒/次,3次/d,2組治療時間均為3箇月.對患者行磁共振成像檢查,利用流速編碼相位對比技術對右冠狀動脈和左前降支近段血流進行測量,分彆測量2組患者靜息狀態和雙嘧達莫靜脈註射後負荷狀態下的血流,併計算冠狀動脈血流儲備功能(CFR).觀察治療前、治療12週後2組患者冠狀動脈血流儲備功能的變化.結果 2組患者治療前冠狀動脈血流量差異無統計學意義(P＞0.05);觀察組治療12週後左前降支、右冠狀動脈的靜息及負荷狀態血流量均較本組治療前明顯增加,差異有統計學意義[左前降支靜息狀態:(1.82±0.33) ml/s比(1.35±0.36) ml/s,負荷狀態:(2.81±0.34) ml/s比(1.83±0.32) ml/s;有冠狀動脈靜息狀態:(1.75±0.32) ml/s比(1.67±0.43) ml/s,負荷狀態:(3.21±0.25) ml/s比(1.75±0.34) ml/s,P＜0.05];對照組左前降支、右冠狀動脈的靜息狀態下血流量較治療前增加,差異有統計學意義[(1.65±0.32) ml/s比(1.39±0.35) ml/s,(1.74±0.38) ml/s比(1.37±0.29) ml/s,P＜0.05],負荷狀態下血流量差異無統計學意義(P＞0.05),治療12週後,觀察組左前降支、右冠狀動脈治療後的靜息及負荷狀態下血流量均高于對照組,差異有統計學意義(P＜0.05);觀察組治療12週後左前降支及右冠狀動脈的CFR明顯高于本組治療前及對照組治療後,差異有統計學意義[左前降支:(3.36±0.36) ml/s比(2.29±0.30)、(2.55±0.43) ml/s,右冠狀動脈:(3.11±0.26)ml/s比(2.38±0.36)、(2.58±0.31) ml/s,P＜0.05],而對照組左前降支及右冠狀動脈的CFR與治療前比較差異無統計學意義(P＞0.05).結論 通心絡膠囊可改善冠狀動脈慢血流患者的血流量緩慢狀態,增加其冠狀動脈血流儲備功能.
목적 채용무창자공진혈류측량기술평고통심락효낭대관상동맥결구정상단혈류완만환자혈류저비공능적영향.방법 선택2011년3월지2014년5월재수도의과대학부속북경안정의원인흉통증상행관상동맥조영검사진단위관상동맥만혈류(CSF)적환자71례,채용수궤수자표법분위대조조(33례)화관찰조(38례).대조조급여상규치료(초산지류、아사필림급아탁벌타정),관찰조재대조조기출상구복통심락효낭3립/차,3차/d,2조치료시간균위3개월.대환자행자공진성상검사,이용류속편마상위대비기술대우관상동맥화좌전강지근단혈류진행측량,분별측량2조환자정식상태화쌍밀체막정맥주사후부하상태하적혈류,병계산관상동맥혈류저비공능(CFR).관찰치료전、치료12주후2조환자관상동맥혈류저비공능적변화.결과 2조환자치료전관상동맥혈류량차이무통계학의의(P＞0.05);관찰조치료12주후좌전강지、우관상동맥적정식급부하상태혈류량균교본조치료전명현증가,차이유통계학의의[좌전강지정식상태:(1.82±0.33) ml/s비(1.35±0.36) ml/s,부하상태:(2.81±0.34) ml/s비(1.83±0.32) ml/s;유관상동맥정식상태:(1.75±0.32) ml/s비(1.67±0.43) ml/s,부하상태:(3.21±0.25) ml/s비(1.75±0.34) ml/s,P＜0.05];대조조좌전강지、우관상동맥적정식상태하혈류량교치료전증가,차이유통계학의의[(1.65±0.32) ml/s비(1.39±0.35) ml/s,(1.74±0.38) ml/s비(1.37±0.29) ml/s,P＜0.05],부하상태하혈류량차이무통계학의의(P＞0.05),치료12주후,관찰조좌전강지、우관상동맥치료후적정식급부하상태하혈류량균고우대조조,차이유통계학의의(P＜0.05);관찰조치료12주후좌전강지급우관상동맥적CFR명현고우본조치료전급대조조치료후,차이유통계학의의[좌전강지:(3.36±0.36) ml/s비(2.29±0.30)、(2.55±0.43) ml/s,우관상동맥:(3.11±0.26)ml/s비(2.38±0.36)、(2.58±0.31) ml/s,P＜0.05],이대조조좌전강지급우관상동맥적CFR여치료전비교차이무통계학의의(P＞0.05).결론 통심락효낭가개선관상동맥만혈류환자적혈류량완만상태,증가기관상동맥혈류저비공능.
Objective To investigate the effect of Tongxinluo capsule on coronary flow reserve in patients with conorary slow flow (CSF) by magnetic resonance (MR) flow measurement technique.Methods A total of 71 patients with CSF confirmed by coronary angiography were randomly divided into observation group (38 cases)and control group (33 cases).Control group was given conventional treatment (nitrates, aspirin and Simvastatin),observation group was additionally given Tongxinluo capsule (3 capsules/time, 3 times/d) on the basis of conventional treatment.The treatment was lasted for 12 weeks.Before and 12 weeks after treatment, the MR examination and velocity encoding phase contrast (VEPC) were used to measure the flow of right coronary artery (RCA) and proximal segments of the left ascending artery (LAD);the flows at rest and stress status (intravenous dipyridamole)were determined and the coronary flow reserve (CFR) was calculated based on the forma.Results The flow and CFRs of LAD and RCA were not significantly different between groups before treatment (P ＞0.05).After 12 weeks of treatment, the flows of LAD and RCA in observation group were significantly increased compared with those before treatment at rest [(1.82 ±0.33) ml/s vs (1.35 ±0.36) ml/s, (1.75 ±0.32) ml/s vs (1.67 ±0.43) ml/s] and at stress status [(2.81 ±0.34) ml/s vs (1.83±0.32) ml/s, (3.21 ±0.25) ml/s vs (1.75 ±0.34) ml/s] (P＜0.05);the flows of LAD and RCA in control group were significantly increased compared with those before treatment at rest[(1.65 ±0.32) ml/s vs (1.39±0.35) ml/s, (1.74 ±0.38) ml/s vs (1.37 ±0.29) ml/s] (P＜0.05), but no at stress status (P ＞0.05);after 12 weeks of treatment, the flows of LAD and RCA at rest and stress status in observation group were significantly higher than those in control group (P ＜0.05).After treatment, the CFRs of LAD and RCA in observation group were significantly higher than that before treatment and that in control group [(3.36 ± 0.36)ml/s vs (2.29±0.30), (2.55 ± 0.43) ml/s, (3.11 ± 0.26) ml/s vs (2.38 ±0.36), (2.58±0.31)ml/s] (P＜0.05);the CFRs of LAD and RCA in control group were not significantly changed after treatment (P ＞ 0.05).Conclusion Tongxinluo capsule can improve the blood flow and coronary flow reserve in the patients with CSF.
