当归活性成分阿魏酸钠干预老年冠状动脉粥样硬化性心脏病心绞痛患者血液抗氧化能力和保护血内皮细胞功能

Interventional effects of sodium ferulate on anti-oxidization of blood and protection of vascular endothelial function in elderly patients with coronary atherosclerotic heart disease and angina

目的:观察中药当归提取的主要活性成分阿魏酸钠对老年冠状动脉粥样硬化性心脏病(简称冠心病)心绞痛患者血浆及红细胞中过氧化脂质含量和超氧化物歧化酶活力、全血谷胱甘肽过氧化物酶活性、红细胞过氧化氢酶活性、血浆内皮素和一氧化氮水平的影响。方法:①选择2004-06/2005-06吉林大学第一医院老年病科住院老年冠心病心绞痛患者42例(男35例,女7例)为治疗组。年龄61～77岁。均按国际心脏病学会和及世界卫生组织制定的缺血性心脏病的命名和诊断标准诊断为冠心病心绞痛。选择同期本院年度进行健康体检人员40名男性为对照组,年龄58～76岁。纳入对象均对检测指标知情同意。治疗组给予阿魏酸钠注射液[巴里莫尔制药(通化)有限公司,生产批号20060501]300mg加入50g/L葡萄糖注射液250mL,静脉滴注,1次/d,疗程2周。②治疗组患者于治疗前和治疗2周末,对照组于约定日,采用硫代巴比妥酸显色法测定血浆及红细胞中过氧化脂质,采用连苯三酚自氧化法测定血浆及红细胞超氧化物歧化酶活性,采用酶动力学法测定红细胞过氧化氢酶活性。采用酶偶联分光光度法测定全血谷胱甘肽过氧化物酶活性。采用硝酸还原法测定血浆一氧化氮水平,采用放射免疫测定血浆内皮素水平。结果:老年冠心病心绞痛患者42例和体检者40名均进入结果分析。①阿魏酸钠的清除氧自由基能力:治疗组治疗前血浆和红细胞过氧化脂质含量明显高于对照组(P<0.01),血浆和红细胞超氧化物歧化酶活性、红细胞过氧化氢酶和谷胱甘肽过氧化物酶活性明显低于对照组(P<0.01)。治疗组治疗后血浆和红细胞过氧化脂质含量明显低于治疗前(P<0.05),血浆和红细胞超氧化物歧化酶活性、红细胞过氧化氢酶和谷胱甘肽过氧化物酶活性明显高于治疗前(P<0.05～0.01)。说明阿魏酸钠有清除自由基、减轻膜脂质过氧化、提高抗氧化酶活性的作用。②阿魏酸钠对血管内皮功能的影响:治疗组治疗前血浆一氧化氮水平为(21.1±11.7)μmol/L,低于对照组[(36.4±10.2)μmol/L,P<0.01],血浆内皮素水平为(94.4±16.9)ng/L,高于对照组[(51.8±17.7)ng/L,P<0.01]。治疗组治疗后血浆一氧化氮水平为(34.7±10.9)μmol/L,高于治疗前(P<0.01),血浆内皮素水平为(65.4±17.4)ng/L,低于治疗前(P<0.01)。结论:阿魏酸钠干预老年冠心病心绞痛患者具有清除自由基、减轻膜脂质过氧化、提高抗氧化酶活性的作用;同时可降低血浆内皮素水平,升高一氧化氮水平,从而改善血管内皮功能。

AIM： To observe the effects of sodium ferulate, the main active component extracted from Chinese angelic, on the activities of lipid peroxide （LPO） and superoxide dismutase （SOD） in serum and red cells, the glutathione peroxidase （GSH-px） activity in whole blood, catalase （CAT） activity in red cells and levels of plasma endothelin （ET） and nitric oxide （NO） in patients with coronary atherosclerotic heart disease and angina. METHODS： ① Forty-two elderly inpatients with coronary atherosclerotic heart disease angina （35 males, 7 females） with an age ranged 61-77 years were selected from the First Hospital of Jilin University between June 2004 and June 2005 and taken as the treatment group. Patients in the treatment group were diagnosed as coronary heart disease angina and named after ischemic heart disease designed by International Society of cardiology （ISC） and WHO. Meanwhile, 40 male people received health examination in the hospital with an age ranged 58-76 years were selected and taken as the control group. All participants knew and agreed with the detection. Patients in the treatment group were intravenously dropped with 300 mg of sodium ferulate injection （manufactured by Barrimore Pharmaceutic Co., Ltd. with the batch number of 20060501） by added with 250 mL of glucose injection （50 g/L） once a day for totally 2 weeks. ② The following examination was conducted in patients in the treatment group respectively before treatment and at the end of the 2^nd week as well as in subjects in the control group on the given day： The thiobarbituric acid coloration was used to determine the levels of LPO in plasma and red cells, and autoxidation of thepyrogallol was adopted to determine the SOD activity in plasma and red cells; the enzyme kinetics was used to determine the CAT activity in red cells; the activity of whole-blood GSH-px was detected by enzyme coupling spectrophotometry; the levels of plasma NO was determined by nitric acid reductase, and level of ET was determined by immunohistochemical methods. RESULTS： A total of 42 elderly patients with coronary heart disease angina and 40 persons received health examination were involved in the result analysis, ① The capacity of sodium ferulate in removing oxygen free radical： the levels of LPO in plasma and red cells before treatment in the treatment group was significantly higher than that in the control group （P 〈 0.01）, whereas the activities of SOD in plasma and red cells, CAT and GSH-px in red cells were obviously lower than those in the control group （P 〈 0.01）. The levels of LPO in plasma and red cells in the treatment group after treatment was remarkably lower than that before treatment （P 〈 0.05）, whereas the activity of SOD in plasma and red cells and the activities of cat AND gsh-PX in red cells were markedly higher than those before the treatment （P 〈 0.05-0.01）, which indicated that sodium ferulate could remove free radical, reduce the peroxidation of membrane lipid and enhance LPO activity.② The effect of sodium ferulate on vascular endothelial functions： the level of plasma NO in the treatment group before treatment was （21.1±11.7）, which was lower than that in the control group [（36.4±10.2） μmol/L ,P 〈 0.01],and the level of plasma ET was （94.4±16.9） ng/L, which was higher than that in the control group [（51.8±17.7） ng/L,P 〈 0.01]. The level of plasma NO in the treatment group after treatment was （34.7±10.9） μmol/L, which was higher than that before treatment （P 〈 0.01）, and the level of plasma ET was （65.4 ±17.4） ng/L, which was lower than that before the treatment （P 〈 0.01 ）. CONCLUSION： Sodium ferulate has effects of removing free radical, decreasing the level of serum LPO and increasing the activity of antioxidant enzymes in elderly patients with coronary heart disease angina, which can simultaneously decrease the level of ET and increase the level of NO, thus improve the vascular endothelial function.