益气活血疗法对卒中高危人群血浆组织型纤溶酶原激活物释放的影响

Effect of benefiting Qi and promoting blood therapy(益气活血疗法) on the blood plasma levels of tissue plasminogen activator in a crowd of people with stroke at high risk

目的观察卒中高危人群血浆组织型纤溶酶原激活物(t-PA)活性的变化,从而了解卒中高危人群凝血与纤溶功能状况,为以益气活血法预防卒中临床方案的实施提供依据。方法选择本院门诊就诊的患者,按诊断和治疗分为卒中高危组、治疗组;选择同期健康体检者作为正常对照组。治疗组在治疗前及治疗后,正常对照组在查体时各采一次空腹肘静脉血,卒中高危组实验前后各采血一次,采用发色底物法测定血浆中(t-PA)活性。结果正常对照组(50例)血浆t-PA活性〔(0.576±0.052)kU/L〕>治疗组〔51例,(0.513±0.066)kU/L〕>卒中高危组〔51例,(0.411±0.078)kU/L〕。统计学分析显示:正常对照组显著高于卒中高危组(P<0.05),治疗组显著高于卒中高危组,但仍低于正常对照组(P均<0.05)。结论①有卒中先兆症状的人群血浆t-PA活性普遍降低;②血浆t-PA活性对卒中高危人群具有预测价值;③益气活血疗法有利于活化血管内皮细胞的分泌功能,提高人体血浆中t-PA的活性。

Objective To observe the changes of activity of plasma tissue plasminogen activator （t-PA） in a crowd of people with stroke at high risk in order to realize the functional status of blood coagulation and fibrinolysis in the crowd and provide a clinical practical basis for prevention of stroke with traditional Chinese medicine therapy of benefiting Qi and promoting blood （益气活血疗法）. Methods According to the diagnosis and treatment, people coming to out-patient clinic were divided into two groups： stroke with high risk group （n=50） and treatment group （n=51）; meanwhile, 50 cases with health check-up were elected as normal control group. Blood samples collected from ulnar vein at empty stomach were adopted respectively, collected once before and after treatment in treatment group, once at health check-up in normal control group, and once before and after experiment in stroke with high risk group. The activity of plasma t-PA was determined by enzyme assay equipment with luminescence substrate method. Results The plasma activity of t-PA in treatment group [（0.513±0.066） kU/L] was lower than that in normal control group [（0.576±0. 052） kU/L] and higher than that in stroke with high risk group [（0. 411±0. 078） kU/L]. The results of comparison in the three groups were that the activity of t-PA in normal control group and treatment group were markedly higher than that in stroke with high risk group, but the activity of t-PA in treatment group was still significantly lower than that in normal control group （both P〈0.05）. Conclusion ①Generally, the plasma activity of t-PA decreases in a crowd with stroke pre-symptom. ②The plasma activity of t-PA has prognostic value in a crowd with stroke at high risk. ③Benefiting Qi and promoting blood therapy is beneficial to the activation of the vascular endothelial cells to secrete and raise the plasma activity of t-PA in human body.