ANGIOGENIC EFFECTS OF HEPARIN FRAGMENTS IN CORONARY ARTERY DISEASE

先前在狗身上的研究表明，肝素与 心肌缺血(心肌供氧不足)可 刺激心脏(络脉)新血管的生长。 在一项安慰剂对照的双盲研究中，我们希望检查 低分子肝素(Fragmin)对大鼠脑缺血再灌注损伤的影响 运动中发生心肌缺血的患者，谁有冠状动脉 疾病。患者接受法格明皮下注射一个月，并有 每天重复3次运动训练，持续2周。共有10名患者 用法格明治疗，13用安慰剂治疗。80%的接受治疗的患者和 31%的控制组的心率压力乘积在 在法格明治疗一个月后进行锻炼(p=0.055)。锻炼 所有接受治疗的患者的缺血持续时间也都有所改善 法格明，但只有62%的安慰剂治疗患者。然而， 利率压力乘积(抵押品的一种衡量标准)增加的幅度 生长)在两组之间没有显著差异。因此，在这个过程中 初步调查，有一些证据表明 Fragmin和缺血可能是血管生成的(改善侧枝生长) 患有冠状动脉疾病的患者。然而，结果需要是 得到了一项大规模研究的证实。

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.