关键词: 冠状动脉慢血流；依那普利；反搏动术, 体外；内皮功能；治疗结果

Abstract: Objective　To investigate the clinical effect of enalapril combined with external counter pulsation（ECP） on the inflammatory factors and vascular endothelial function in patients with coronary slow flow（CSF），providing a reference for the treatment of this disease.Methods　A total of 90 cases of CSF were enrolled from the Second Affiliated Hospital of Zhengzhou University from December 2013 to June 2017，and divided into the control group（n=30），enalapril group（n=30） and enalapril combined with ECP group（n=30） by block randomization method，treated by basic drug treatment　and symptomatic treatment，basic drug treatment，symptomatic treatment combined with enalapril（5 mg/d） treatment，basic drug treatment，symptomatic treatment，enalapril（5 mg/d） treatment combined with ECP，respectively.We collected their baseline characteristics，measurement results of levels of hypersensitive C-reactive protein（hs-CRP），interleukin-6 （IL-6），lipoprotein-associated phospholipase A2（Lp-PLA2），brachial flow-mediated dilation（FMD），endothelin-1（ET-1） and NO measured before treatment and on the 15th day after treatment，as well as corrected TIMI frame count （cTFC），Seattle Angina Questionnaire （SAQ） score，and duration of treadmill exercise testing（TET） before treatment and 6 months after treatment.Results　The Lp-PLA2，ET-1 decreased significantly but NO increased significantly in enalapril group on the 15th day after treatment，the cTFC decreased significantly in enalapril group 6 months after treatment（P<0.05），the IL-6，Lp-PLA2 ，ET-1 decreased obviously，but FMD，NO increasedand significantly in enalapril combined with ECP group on the 15th day after treatment（P<0.05），the cTFC decreased obviously ，SAQ score increased and the duration of TET prolonged substantially in enalapril combined with ECP group 6 months after treatment（P<0.05）．On the 15th day after treatment compared with the control group，the Lp-PLA2，ET-1 and cTFC increased significantly but FMD，NO decreased significantly in the enalapril group（P<0.05），6 months after treatment the cTFC increased significantly in the enalapril group（P<0.05）．On the 15th day after treatment，the IL-6，Lp-PLA2，ET-1 decreased significantly but NO significantly in the enalapril combined with ECP group than in other two groups （P<0.05）．6 months after treatment，the cTFC decreased significantly but SAQ score，duration of TET increased significantly in the enalapril combined with ECP group than in other two groups （P<0.05）．Conclusion　As the good clinical response achieved in SCF patients showed，enalapril combined with ECP significantly improved SCF，which might be related to the improvement of inflammation and vascular endothelial function.

Key words: Coronary slow flow；Enalapril；Counterpulsation, external；Endothelium；Treatment outcome