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目的:研究血浆一氧化氮和内皮素在银杏叶提取物治疗老年冠心病中的作用。方法:采用西药常规和银杏叶提取物注射液治疗老年冠心病,60例经冠状动脉造影证实的老年冠心病患者随机分为治疗组和对照组(各30例),观察心绞痛症状,检测老年冠心病患者冠状动脉左前降支(LAD)血流;并采用硝酸还原酶法和放免法测定血浆一氧化氮(NO)和内皮素(ET)水平。结果:治疗组的总有效率优于对照组(P<0.01);银杏叶提取物显著增加LAD舒张期峰值流速(P<0.01),收缩期峰值流速(P<0.01),舒张期时间速度积分(P<0.01);同时,血浆NO水平升高(P<0.01),ET水平下降(P<0.01),NO/ET比值升高(P<0.01);而对照组冠脉血流,血浆NO和ET水平无明显变化(P>0.05)。Pearson线性相关分析显示,LAD血流流速的增加与血浆NO水平升高,ET水平下降,以及NO/ET比值升高显著相关(P<0.01)。结论:银杏叶提取物注射液可有效治疗老年冠心病心绞痛,其机制可能与改善血浆NO和ET平衡有关。
Objective: To study the role of plasma nitric oxide and endothelin in the treatment of senile coronary heart disease with Ginkgo biloba extract. Methods: Western medicine and Ginkgo biloba extract injection for senile coronary heart disease, 60 cases of elderly patients with coronary heart disease confirmed by coronary angiography were randomly divided into treatment group and control group (30 cases each), observed angina pectoris, Blood flow of left anterior descending coronary artery (LAD) was measured in patients with heart disease. Nitric acid reductase and radioimmunoassay were used to determine plasma nitric oxide (NO) and endothelin (ET) levels. Results: The total effective rate of the treatment group was better than that of the control group (P <0.01); Ginkgo biloba extract significantly increased the diastolic peak flow velocity (P <0.01), peak systolic flow velocity (P <0.01), diastolic time velocity integral (P <0.01). At the same time, plasma NO level increased (P <0.01), ET level decreased (P <0.01) and NO / ET ratio increased And ET levels did not change significantly (P> 0.05). Pearson linear correlation analysis showed that the increase of LAD blood flow velocity was significantly associated with the increase of plasma NO level, the decrease of ET level and the increase of NO / ET ratio (P <0.01). Conclusion: Ginkgo biloba extract injection can effectively treat angina pectoris in elderly patients with coronary heart disease. The mechanism may be related to the improvement of plasma NO and ET balance.