云南白药对围手术期血小板表面糖蛋白及超微结构影响的研究

The Effect of Yunnan Baiyao on Ultrastructure and Perioperation Surface Glycoprotein of Platelets

目的 :研究云南白药对围手术期病人血小板表面糖蛋白GPIIb,GPIIIa,GMP14 0 及血小板超微结构的影响 .方法 :1 2 0例手术病人分三组 ,对照组 (A组 ) 40例 ,肿瘤手术组 (B组 ) 40例 ,非肿瘤手术组 (C组 ) 40例 ,采用双盲法 ,实验组服用“云丰”牌云南白药胶囊 0 5g/次 ,对照组服用空胶囊 ,每天 4次 ,连服 3d,应用流式细胞术 (FCM)检测其服药前、手术前、手术后的GPIIb,GPIIIa,GMP14 0 表达的改变及观察D-二聚体以及血小板超微结构的变化 .结果 :云南白药能增加血小板GPIIb,GPIII14 0 的表达 (P <0 0 1 ) ,D -二聚体在实验组 (B与C组 )与对照组阳性率并不增高 (P >0 0 5 ) ,电镜显示服用云南白药后 ,活化血小板增多 ,可见血小板表面突起增多 ,血小板小管开放 ,释放增多 .结论 :服用此剂量的云南白药能增加血小板活性、血小板聚集及与纤维蛋白原受体的结合能力 ,服药后围手术期无血栓形成危险 .

Objective:To study the effect of Yunnan Baiyao on platelet surface glycoprotein(GPⅡ b,GPⅢ a,GMP 140 )and ultrastructure in perioperation.Methods:20 patients for surgery were divided into 3 groups:control group A(n=40),tumor group B(n=49)and non-tumor group C(n=40).Yunnan Baiyao were given 0.5 qidfor 3 days orally in group B and C,but empty capsules in group A.The preoperative and postoperative expressions of the platelet surface glycoprotein(GPⅡ b,GPⅢ a,GMP 140 )and dimer were detected with FCM,and ultrastructure of platelets were observed with electro microscopy,which were analyzed by correspond statistic method.Results:The preoperative and postoperative expressions of the Yunnan Baiyao(GPⅡ b,GPⅢ a,GMP 140 )were increased in group B and C with no change in control group(P<0.01).Dimer was not changed in B,C and A groups(P>0.05).Increased active platelets were seen under electro microscopy in B and C group.Conclusions:Patients given Yunnan Baiyao 0.5 qidfor 3 days orally can increase the active collection and combination with platelet fibrinogen.The given dosage of Yunnan Baiyao does not cause the risk of thrombosis.