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JAHA：有症状糖尿病患者但无阻塞性冠状动脉疾病患者雷诺拉嗪疗效如何？

2017-05-07 xing.T MedSci原创

雷诺拉嗪糖尿病阻塞性冠状动脉疾病
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由此可见，在有症状的糖尿病但无阻塞性冠状动脉疾病的患者中，雷诺拉嗪并没有改变运动刺激的心肌血流量或CFR，但可以适度改善舒张功能。基础CFR受损更严重的患者可能从雷诺拉嗪的治疗中获得更多的益处。

针对血管造影没有阻塞性冠状动脉疾病的心肌缺血患者的治疗相对有限。在这些患者中，特别是那些患有糖尿病的患者，弥漫性冠状动脉粥样硬化和微血管功能障碍是一种常见的表型，并可能伴随着舒张功能障碍。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，研究人员旨在确定雷诺拉嗪是否可以提高有症状的糖尿病但无阻塞性冠状动脉疾病患者运动刺激的心肌血流量和心功能。

研究人员进行了一项双盲交叉试验，以1:1的比例随机分配到安慰剂或雷诺拉嗪治疗组。在基础和治疗4周后，研究人员采用13N-氨心肌灌注的正电子发射断层扫描测定了参与者休息时和仰卧自行车运动时左心室心肌血流和冠状动脉血流储备（CFR；主要终点），也进行了静息超声心动图检查。研究人员采用多层次混合效应线性回归法来确定治疗效果。

三十五名患者满足了研究纳入标准，研究人员发现雷诺拉嗪并没有显着改变休息或运动后左室心肌血流量或CFR。然而，基础CFR较低的患者接受雷诺拉嗪（r=-0.401，P=0.02）治疗后相比于安慰剂（r=-0.188，P=0.28）治疗才更有可能经历CFR改善。

由此可见，在有症状的糖尿病但无阻塞性冠状动脉疾病的患者中，雷诺拉嗪并没有改变运动刺激的心肌血流量或CFR，但可以适度改善舒张功能。基础CFR受损更严重的患者可能从雷诺拉嗪的治疗中获得更多的益处。

原始出处：

Nishant R. Shah,et al. Ranolazine in Symptomatic Diabetic Patients Without Obstructive Coronary Artery Disease: Impact on Microvascular and Diastolic Function.JAHA.2017. https://doi.org/10.1161/JAHA.116.005027

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    2017-08-06 hmwwww

    #疾病患者#

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    2017-10-30 echonoir

    #雷诺拉嗪#

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    2017-09-06 tomyang96

    #阻塞#

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    2017-05-19 flysky120

    糖尿病对患者损伤

    0

  5. 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    2017-05-11 flysky120

    学习一下知识

    0

  6. 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    2017-05-09 charl1234569

    #阻塞性冠状动脉疾病#

    0

  7. 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GetPortalCommentsPageByObjectIdResponse(id=195707, encodeId=ee71195e073c, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue May 09 08:11:38 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 howi

    #冠状动脉疾病#

    0

  8. 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createdName=echonoir, createdTime=Mon Oct 30 06:54:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696716, encodeId=776d1696e1612, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Wed Sep 06 10:54:00 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199957, encodeId=e37819995e34, content=糖尿病对患者损伤, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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topicId=null, topicList=[TopicDto(id=97655, encryptionId=eb6b9e65541, topicName=阻塞性冠状动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64696828888, createdName=charl1234569, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1252891, encodeId=f21a12528917c, content=<a href='/topic/show?id=463230886b8' target=_blank style='color:#2F92EE;'>#冠状动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30886, encryptionId=463230886b8, topicName=冠状动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267438, encodeId=6971126e438fa, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474169, encodeId=b2a214e41695f, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195707, encodeId=ee71195e073c, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue May 09 08:11:38 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 zhaohui6731

    #AHA#

    0

  9. 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style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474169, encodeId=b2a214e41695f, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195707, encodeId=ee71195e073c, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue May 09 08:11:38 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 xue8604

    #糖尿病患者#

    0

  10. 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style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474169, encodeId=b2a214e41695f, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Tue May 09 12:54:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195707, encodeId=ee71195e073c, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue May 09 08:11:38 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-09 flysky120

    学习一下知识

    0

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