ANGIOGENIC EFFECTS OF HEPARIN FRAGMENTS IN CORONARY ARTERY DISEASE

以前在狗身上的研究已经证明，肝素与 心肌缺血（心肌供氧不足）可 刺激心脏中新血管（侧枝）的生长。 在一项安慰剂对照的双盲研究中，我们希望检查 缺血和低分子量肝素治疗（法安明）对 运动时心肌缺血患者，冠状动脉 疾病 患者皮下注射法安明1个月， 重复运动训练，每天3次，持续2周。 10例患者 13例接受法安明治疗，13例接受安慰剂治疗。80%的患者和 31%的对照组在治疗期间心率压力乘积有所改善。 法安明治疗一个月后的运动（p=0.055）。行使 缺血持续时间也在所有接受 法安明，但只有62%的安慰剂治疗的患者。 但 利率-压力乘积的增加幅度（抵押品的测量 生长）在组之间没有显著差异。 因此，在这 初步调查，有证据表明， 法安明和缺血可能是血管生成（改善侧支生长）， 冠心病患者。 然而，结果需要 这是一项大规模的研究证实的。

Previous studies in dogs have demonstrated that heparin combined with myocardial ischemia (deprivation of oxygen supply to the heart muscle) can be a stimulus for growth of new blood vessels in the heart (collaterals). In a placebo controlled, double-blind study, we wished to examine the effects of ischemia and low molecular weight heparin therapy (Fragmin) in patients with myocardial ischemia during exercise, who had coronary artery disease. Patients were given subcutaneous Fragmin for one month and had repeat exercise training 3 times a day for 2 weeks. There were 10 patients treated with fragmin and 13 with placebo. 80% of the treated patients and 31% of the controls had improvement in rate pressure product during exercise after one month of treatment with Fragmin (p=0.055). Exercise duration to ischemia was also improved in all patients treated with Fragmin, but in only 62% of placebo treated patients. However, the magnitude of increase in the rate-pressure product (a measure of collateral growth) was not significantly different between the groups. Thus in this preliminary investigation, there is some evidence that combination of Fragmin and ischemia may be angiogenic (improves collateral growth) in patients with coronary artery disease. However, the results need to be confirmed by a large scale study.