The Relationship Between Slow Flow Of Coronary Artery And Vascular Endothelium And Drug Intervention

With the widespread of coronary angiography techniques,more and more cardiovascular interventional physicians have found that there are statistics showing that slow coronary blood flow exists in patients undergoing coronary angiography.Coronary angiography was performed on patients suspected of cardiovascular disease.After thrombolytic therapy,coronary artery spasm,coronary artery dilatation,cardiomyopathy,valvular disease were excluded after coronary angioplasty.However,the phenomenon of delayed perfusion was found in the coronary artery.This phenomenon is called primary coronary slow flow phenomenon,but the mechanism is not clear.This paper discusses the relationship between slow blood flow and endothelium and drug intervention.Objective1.To investigate the endothelial function of patients with slow blood flow:homocysteine,low density lipoprotein(LDL),nitric oxide(no)and endothelin-1(ET-1).To investigate the correlation between the pathogenesis of slow blood flow and endothelial function.2.To compare the changes of TIMI(myocardial infarction thrombolytic therapy in myocardial arction)with Shexiang Tongxin dropping pill for 5 minutes and one month after treatment.To investigate the intervention of Shexiang Tongxin dropping pills in patients with slow blood flow.MethodsExperiment 1:selected patients who had chest pain and chest tightness in our hospital for coronary angiography,and measured the corrected TIMI frame number of patients who met the criteria of entering the group.Experimental group:≥27 frames for patients with slow blood flow,control group:<27 frames for patients with normal blood flow,detection of endothelial function of the index of reaction to the endothelium,low density lipoprotein(LDL),uric acid,homocysteine;Experiment 2:after taking Shexiang Tongxin dropping pills for 5 minutes,the corrected TIMI frames were measured again in the experimental group,and the NO,ET-1,LDL,uric acid and homocysteine were detected again in the experimental group after one month of operation.Statistical method was used to detect whether the change of TIMI frame number was significant,and whether there was significant difference in endothelial function between the two groups.ResultsThe basic data of experimental group(CSF)and control group(NCF)were compared.Sex,age,hypertension,diabetes,smoking history were compared between the two groups.There was no significant difference between the two groups in the history of drinking.Experiment 1:CSF group(coronary slow flow phenomenon)and NCF group(normal coronary flow)homocysteine 13.74 ±2.58μmol/L vs 12.2 ±2.35μmol/L P<0.05,low density lipoprotein 3.52 ±0.62 mmol/L vs 2.78±0.59 mmol/L.P<0.05,uric acid 370.29±67.68μmol/L vs 320.39±67.68μmol/L P<0.05 mol/L vs 56.37±17.5 μmol/L vs 56.25 ±8.18 μmol/L P<0.05ET-1:203.66±42.84 μmol/L vs 154.57±20.62μmol/L P<0.05.Homocysteine,low density lipoprotein and uric acid ET-1 were significantly increased,while NOS was lower than that in NCF group.The levels of homocysteine,low density lipoprotein,uric acid and ET-1 were positively correlated with the value of CTFC(corrected TIMI frame correcte TIMI frame court),and negatively correlated with the level of NO.Experiment 2:the patients in the experimental group were treated with Shexiang Tongxin dropping pill for 5 minutes and the values of CTFC(corrected TIMI frame correcte TIMI frame court)were measured again.The average CTFC value of the patients was 40.24 ±8.98 frames.The patients were treated with Shexiang Tongxin dropping pills for 5 minutes.The average CTFC:33.91±6.61 frame P<0.05,the difference was statistically significant.HCY:(homocysteine homocysteine)before the application of Shexiang Tongxin dropping pills 13.7 ±2.58 μmol/L,one month after the drug 12.01 ±3.04 μmol/L P<0.05.Uric acid(μmol/L:Shexiang Tongxin dropping pills 370.29±72.18μmol/L,1 month drug 1 month).Months later,334.82±92.76μmol/L(P<0.05).Low density lipoprotein:3.52 ±0.62 mmol/L before Shexiang Tongxin dropping pills,2.46 ±0.73 mmol/L P<0.05.NOSbefore Shexiang Tongxin dropping pills for 1 month,46.37 ± 17.58 μmol/L before Shexiang Tongxin dropping pills,One month after administration,58.33 ±12.31 μmol/L P<0.05.ET-1:203.66±42.84 μmol/L before Shexiang Tongxin dropping pill,and 174.84 ±30.06 μmol L/L after one month(P<0.05).Conclusion1、The levels of homocysteine,low density lipoprotein,uric acid and ET-1 in patients with slow blood flow were significantly higher than those in normal blood flow group,while the levels of NOS were decreased,and the levels of homocysteine,low density lipoprotein,uric acid and ET-1 were positively correlated with CTFC and negatively correlated with the level of NO.It suggests that endothelial dysfunction exists in patients with slow blood flow.2、After the application of Shexiang Tongxin dropping pills,the blood flow velocity of patients with slow blood flow can be improved immediately,and the endothelial function of patients can be improved after one month’s application.