培哚普利对冠心病患者循环血内皮祖细胞及血管内皮功能的影响

摘要

目的：探讨不同剂量培哚普利在冠心病治疗中对循环血内皮祖细胞（EPCs）水平及血管内皮功能的影响。　　方法：选取我院经冠状动脉造影确诊为冠心病的患者84例，随机分为对照组（n=27，给予常规药物），小剂量组（n=29，给予常规药物+4 mg培哚普利）和大剂量组（n=28，给予常规药物+8 mg培哚普利）。随访12周，治疗前后各组分别采用流式细胞术检测EPCs水平，采用超声测定肱动脉血管舒张功能（FMD），同时检测高敏C反应蛋白（hs-CRP）、血管紧张素II（Ang II）水平。　　结果：治疗12周后，对照组、小剂量组及大剂量组患者较治疗前循环血EPCs、肱动脉FMD均有不同程度的增高，hs-CRP水平均有不同程度的降低（ P<0.05）；小剂量组及大剂量组Ang II较治疗前均有不同程度的降低（P<0.05）；治疗后，小剂量组及大剂量组循环血EPCs、肱动脉FMD均显著高于对照组,hs-CRP及Ang II均显著低于对照组（ P<0.01），同时，与小剂量组比较，大剂量组循环血EPCs及FMD均明显升高，hs-CRP及Ang II均明显降低（ P<0.05）。　　结论：培哚普利对循环血EPCs有一定的动员作用，可显著改善血管内皮功能,且较大剂量效果更显著。%Objective: To investigate the effect of different doses of perindopril on peripheral endothelial progenitor cells (EPCs) and vascular endothelial function in patients with coronary artery disease (CAD) . Methods: A total of 84 CAD patients with coronary angiography confirmed diagnosis were divided into 3 groups: Control group, the patients received routine medication, n=27. Low-dose group, the patients received routine medication with perindopril for 4mg, n=29. High-dose group, the patients received routine medication with perindopril for 8mg, n=28. All patients were treated for 12 weeks. The EPCs level was detected by flow cytometry assay, flow-mediated-dilation (FMD) function in brachial artery was measured by ultrasound and plasma levels of high sensitivity C-reactive protein (hs-CRP), angiotensin II (AngII) were examined in all groups. Results: ① After12 weeks of treatment, the EPCs level and FMD function had certain improvement, hs-CRP level decreased in various degrees in all 3 groups, P<0.05, and AngII level decreased in both perindopril groups, P<0.05.②After treatment, compared with Control group, both perindopril groups had the increased EPCs level and FMD function, while decreased levels of hs-CRP and AngII, P<0.01.③Compared with Low-dose group, High-dose group showed increased EPCs level and FMD function, decreased levels of hs-CRP and AgnII, P<0.05. Conclusion: Perindopril may mobilize peripheral EPCs at certain point, and therefore improve endothelial function, the higher dose of perindopril may have better effect.