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通过肱动脉血流介导的血管舒张(FMD)与硝酸甘油介导的血管舒张(NMD)比值评估L-瓜氨酸对已知冠心病患者内皮功能的短期影响:一项随机交叉临床试验(临床试验编号:NCT02638727)。

The Assessment of short-term effect of L-Citrulline on endothelial function via FMD to NMD ratio in known CAD patients: A randomized, cross-over clinical trial (Clinical trial number: NCT02638727).

作者信息

Safi Morteza, Mahjoob Mohammad Parsa, Nateghi Saeed, Khaheshi Isa, Akbarzadeh Mohammad Ali, Naderian Mohammadreza

出版信息

Rom J Intern Med. 2017 Mar 1;55(1):23-27. doi: 10.1515/rjim-2016-0045.

DOI:10.1515/rjim-2016-0045
PMID:27648629
Abstract

BACKGROUND

Recent studies have confirmed the essential and paramount role of the L-Citrulline on the nitric oxide regulation and the endothelial function improvement.

MATERIALS AND METHODS

In this cross-over clinical trial, thirty patients, diagnosed with coronary artery disease (CAD) and flow mediated dilation to nitroglycerin dependent vasodilation (FMD/NMD) ratio less than 1, were included. The patients were randomly divided into two groups of 15 patients and underwent treatment by L-Citrulline or placebo for 15 days, in 2 step protocol. The indicators of assessment in the current study were the ratio of the FMD/NMD and FMD value.

RESULTS

In the current cross-over clinical trial, the mean of FMD to NMD ratio and mean FMD value of all patients before starting the protocol were 0.91 ± 0.08 and 4.04 ± 0.51 mm, respectively. The final results of study showed that following L-Citrulline administration, mean FMD to NMD ratio and mean FMD value were enhanced to: 1.03 ± 0.09 and 4.96 ± 0.72 mm, respectively, which were statistically significant (P<0.001 and P<0.001, respectively). However, following placebo administration, mean FMD to NMD ratio and mean FMD value were receded to: 0.92 ± 0.09 and 4.06 ± 0.22 mm, respectively, which were not statistically significant (P = 0.75 and P = 0.89, respectively). Moreover, the improvement of mean FMD to NMD ratio (0.12 ± 0.02) and mean FMD value (0.92 ± 0.16 mm), following L-Citrulline administration, were statistically significant in comparison with the change of mean FMD to NMD ratio (0.01 ± 0.002) and mean FMD value (0.02 ± 0.003), following placebo administration (P<0.001 and P<0.001, respectively).

CONCLUSION

L-Citrulline treatment can lead to improvement of the endothelial function in patients diagnosed with CAD which are assessed via FMD to NMD ratio FMD value enhancements.

摘要

背景

近期研究证实了L-瓜氨酸在一氧化氮调节和改善内皮功能方面的重要且关键作用。

材料与方法

在这项交叉临床试验中,纳入了30例被诊断为冠心病(CAD)且血流介导的舒张与硝酸甘油依赖性血管舒张(FMD/NMD)比值小于1的患者。患者被随机分为两组,每组15例,按照两步方案接受L-瓜氨酸或安慰剂治疗15天。本研究的评估指标为FMD/NMD比值和FMD值。

结果

在当前的交叉临床试验中,所有患者在开始方案前FMD与NMD比值的平均值为0.91±0.08,FMD值的平均值为4.04±0.51mm。研究的最终结果显示,给予L-瓜氨酸后,FMD与NMD比值的平均值和FMD值分别提高到:1.03±0.09和4.96±0.72mm,具有统计学意义(分别为P<0.001和P<0.001)。然而,给予安慰剂后,FMD与NMD比值的平均值和FMD值分别降至:0.92±0.09和4.06±0.22mm,无统计学意义(分别为P = 0.75和P = 0.89)。此外,与给予安慰剂后FMD与NMD比值的变化(0.01±0.002)和FMD值的变化(0.02±0.003)相比,给予L-瓜氨酸后FMD与NMD比值的平均值(0.12±0.02)和FMD值的平均值(0.92±0.16mm)的改善具有统计学意义(分别为P<0.001和P<0.001)。

结论

L-瓜氨酸治疗可通过FMD与NMD比值及FMD值的提高,改善被诊断为CAD患者的内皮功能。

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