通过刺激新血管生成改善冠状动脉搭桥术患者生活质量的新药理学方法

B. Oleynik, V. A. Evdakov, V. Plechev, Ramil' I. Izhbul'din
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摘要

导语:尽管大多数手术患者的情况得到了客观的改善,并且提供了越来越多的高科技辅助,但这类患者的身体活动和工作能力参数仍然很低。目的:研究具有血管生成特性的5-氧甲基尿嘧啶对冠状动脉搭桥术(CABG)术后早期和远期患者生活质量的影响。材料与方法:随机前瞻性研究分为两组患者:主组(n = 87)在CABG围手术期(术前5天和术后14天),在标准治疗的基础上给予5-氧甲基尿嘧啶药物治疗;对照组(n = 81)给予标准治疗。两组在性别、年龄、基本临床和功能特征以及手术干预特点方面具有可比性。CABG术前(入血管外科)、术后(术后2个月、1618年)采用西雅图心绞痛问卷(Seattle Angina Questionnaire, SAQ)评估患者的生活质量。对照组与主组术前生活质量参数比较,差异无统计学意义。结果:在心肌手术重建术长期(术后1618年)心绞痛严重程度SAQ值为:对照组33.30(20.00-60.00),主组60.00 (33.30-70.00);= 0.0407)。其他SAQ量表,包括身体活动、心绞痛病程稳定性、治疗满意度和对疾病的认知,在CABG后2个月或1618年内,实验组之间没有任何差异。结论:围手术期使用5-羟甲基尿嘧啶仅影响SAQ问卷中生活质量参数心绞痛严重程度的改善,且在CABG长期(术后1618年)组间差异有统计学意义。根据SAQ问卷,在所有随访期间,围手术期潜在使用研究药物对生活质量的其余参数均无影响。
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New Pharmacological Approach to Improvement of Quality of Life of Patients after Coronary Artery Bypass Grafting through Stimulation of Neoangiogenesis
INTRODUCTION: Despite the increased volume of rendered high-tech assistance and objective improvement of the condition of the majority of operated patients, the parameters of physical activity and working capacity in this category of patients remain low. AIM: To study the effect of 5-oxymethyluracil with angiogenic properties on the quality of life of patients in the early and long-term period after coronary artery bypass grafting (CABG). MATERIALS AND METHODS: The randomized prospective study included two groups of patients: the main group (n = 87) which in the perioperative period of CABG (5 days before and 14 days after surgery), in addition to standard therapy, received the drug 5-oxymethyluracil), and the control group (n = 81) which received standard therapy. The groups were comparable in gender, age, basic clinical and functional characteristics and peculiarities of surgical intervention. The quality of life of patients was determined by the Seattle Angina Questionnaire (SAQ) before CABG surgery (upon admission to the vascular surgery department) and after surgery (after 2 months and 1618 years). There were no statistically significant differences in the preoperative parameters of quality of life in the control and main groups. RESULTS: In the long-term period of surgical revascularization of the myocardium (1618 years after the operation) the severity of angina according to SAQ was: in the control group 33.30 (20.00-60.00), in the main group 60.00 (33.30-70.00; р = 0.0407). Other scales of SAQ, including physical activity, stability of anginal course, satisfaction with treatment and perception of the disease, did not demonstrate any differences between the studied groups in 2 months or 1618 years after CABG. CONCLUSION: Perioperative use of 5-oxymethyluracil influenced the improvement of only one parameter of quality of life according to the SAQ questionnaire the severity of angina, with statistically significant differences between the groups in the long-term period of CABG (1618 years after surgery). According to SAQ questionnaire, there was no effect on the remaining parameters of the quality of life with the underlying perioperative use of the studied drug in all follow-up periods.
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