目的：探讨经皮冠状动脉腔内成形术(PTCA)后不同时间冠状动脉非病变血管对不同剂量P物质的舒张作用。

方法：对13例男性冠心病(陈旧性心肌梗塞7例，不稳定性心绞痛6例，年龄59～67岁)患者于PTCA后第1天及3个月进行P物质(13.5 ng、40 ng、135 ng)负荷冠状动脉造影，同时与生理盐水和硝酸甘油的冠状动脉造影相对照，采用XR-70型Coronary analyzer用密度测量法于舒张末期分别测量冠状动脉非病变Ⅰ级，Ⅱ、Ⅲ级血管的中间部位。13名患者测冠状动脉非病变Ⅰ级，Ⅱ、Ⅲ级血管分别为23、19支。

结果：PTCA后第1天冠状动脉非病变Ⅱ、Ⅲ级血管对不同剂量P物质的舒张反应差异性不显著。PTCA后3个月冠状动脉非病变Ⅱ、Ⅲ级血管对不同剂量P物质舒张反应的组间差异性显著。PTCA后3个月冠状动脉非病变Ⅰ级血管依赖性舒张反应较第1天明显，但差异性不显著。PTCA后3个月较第1天冠状动脉非病变Ⅱ、Ⅲ级，Ⅰ级血管对P物质135 ng组的舒张反应差异性显著，但对P物质13.5 ng和40 ng组反应不明显。PTCA后3个月较第1天冠状动脉非病变Ⅱ、Ⅲ级，Ⅰ级血管对硝酸甘油的反应差异性显著。

结论：PTCA后不同时间冠状动脉非病变Ⅰ级血管对P物质的内皮依赖性舒张作用均较强；PTCA后早期冠状动脉非病变Ⅱ、Ⅲ级血管内皮依赖性舒张能力低下，但术后3个月即得到明显恢复。

Endothelium-Dependent vasodilation Effect of Substance P on Non-Affected

Vessels after Percutaneous Transluminal Coronary Angioplasty (Abstract)

Department of Cardiology, The First Affiliated hospital, China Medical University, Shenyang (110001), Liaoning

zhang Yuelan, Zhao Weihua, Jin Lin.

objective: To evaluate the endothelium-dependent vasodilation effect on non-affected vessels by different doses of substance P(SP) after percutaneous transluminal coronary angioplasty (PTCA).

Methods: Thirteen patients with coronary heart disease were given coronary angiography (CAG) with SP load on the first day and3 months after PTCA. SP 13.5 ng、 40 ng、 135 ng were injected into coronary artery separately and CAG was performed 2 minutes after each injection. In control group 2 ml nature saline or 200 μg nitroglycerin (NTG) was given instead of SP. Coronary artery lurminal diameters of non-affected grade 1 and grade 2～3 vessels were measured separately on the recorded film by density measurement.

Results: On the first day after PTCA, the SP had little dilating effect on grade 2～3 vessels in all groups. But different doses of SP dilated grade 2～3 vessels in a dose-dependent manner at 3 months after PTCA (p＜0.05～0.01). all three doses of SP dilated the grade 1 vessels on the first day and at 3 months after PTCA (p＜0.05～0.01).

Conclusion: At different time after PTCA, endothelum-dependent vasodilation on the non-affected grade 1 vessels was better than on the grade 2～3 vessels. In the early period after PTCA, endothelium-dependent vasodilation produced by SP was impaired in non-affected grade 2～3 vessels, but the endothelial dysfunction was ameliorated 3 months after PTCA.