通心络对急性冠状动脉综合征患者介入术后血小板活化及血管内皮功能的影响

The effects of Tongxinluo capsule on platelet activity and vascular endothelium function in patients with ACS after PCI

目的评价通心络胶囊对急性冠状动脉综合征(ACS)介入治疗术后血小板活化状态及血管内皮功能的影响。方法90例ACS患者(ACS组)随机分为通心络胶囊治疗组(45例)和常规治疗组(45例),另选健康对照组45例,分别检测血小板表面活性标记蛋白CD62P、CD63和膜糖蛋白(GP)Ⅱb/Ⅲa,测定血浆血管性假血友病因子(vWF),并测量内皮依赖性血管舒张功能(FMD)。服用通心络胶囊治疗8周后复查上述指标并进行治疗前后比较及两组间比较。结果与健康对照组比较,ACS组患者血小板活化指标CD62P、CD63及GPⅡb/Ⅲa受体复合物显著升高(P<0.01),vWF显著升高(P<0.01),FMD显著降低(P<0.01)。冠状动脉介入术后vWF升高(P<0.05),FMD降低(P<0.05)。与常规治疗组比较,通心络胶囊治疗组更明显降低CD62P、CD63、vWF(P<0.05)及GPⅡb/Ⅲa复合物(P<0.01),增加FMD的水平(P<0.05)。结论通心络胶囊可用于冠状动脉介入术前后预防和治疗冠状动脉内血栓及保护血管内皮功能。

Objective To evaluate the effects of Tongxinluo capsule（TXL） on platelet activity and function of vascular endothelium after percutaneous coronary intervention（PCI） in patients with acute coronary syndrome（ACS）. Methods Ninety patients with ACS were divided randomly into TXL group（45 patients） and control group（45 patients）,45 healthy persons served as healthy control group. Blood CD62P,CD63, GP Ⅱ b/Ⅲ a and Von Willebrand factor （vWF）levels,and flow- mediated dilatation（FMD） in brachial artery were examined before treatment and on second day after PCI in both patient groups. Then the patients in TXL group received TXL treatment for 8 weeks（4capsule tid）, and the results were compared with control（conventional treatment） group. Results The ACS patient blood CD62P,CD63, GPⅡ b/Ⅲa and vWF levels increased significantly（all P 〈0.01）, FMD decreased significantly（ P 〈0.01）, compared with healthy control group. The serum vWF levels increased significantly（ P 〈0.05） and FMD decreased significantly （ P 〈0.05） after PCI. In TXL treatment group, the serum levels of CD62P,CD63, GPⅡ b/Ⅲa and vWF levels decreased significantly（ P 〈0.05 and P 〈0.01）, FMD increased significantly compared with conventional treatment group（ P〈0.05）. Conclusion TXL can inhibit the platelet activity and protect the vascular endothelium function after PCI.