消瘀止血片对出血性血小板病患者凝血酶受体GPⅠb/Ⅸ/Ⅴ及GPⅠbα表达的影响

Effect of Xiaoyu Zhixue Tablet on Expression of Thrombin Receptor Glycoproteins Ⅰb/Ⅸ/Ⅴ and Glycoprotein Ⅰbα in Patients with Hemorrhagic Thrombopathy

目的观察消瘀止血片对出血性血小板病患者凝血酶受体GPⅠb/Ⅸ/Ⅴ复合物及其组分GPⅠbα表达的影响,探讨其治疗该病的可能机制。方法98例出血性血小板病患者随机分为两组,中药组68例用消瘀止血片治疗;西药组30例用安络血、维生素C、K、P治疗,两组均治疗6个月。观察两组治疗后止血疗效及血小板聚集恢复率。采用流式细胞仪检测两组治疗前后及34名健康人的血小板膜糖蛋白GPⅠb/Ⅸ/Ⅴ及GPⅠbα的表达。结果中药组止血总有效率为89.7%,西药组为46.7%,两组比较,差异有统计学意义(u=5.68,P<0.01);中药组血小板聚集功能恢复率67.6%,西药组仅3.3%,两组比较,差异有统计学意义(x^2=34.49,P<0.01)。两组患者治疗前GPⅠb/Ⅸ/Ⅴ及GPⅠbα表达荧光强度均低于健康人(P<0.05);经中药治疗后,患者的上述表达增加,与健康人比较,差异无统计学意义(P>0.05),而明显高于西药组(P<0.05)。结论消瘀止血片在受体蛋白水平上调节血小板凝血酶受体的表达这可能是其治疗出血性血小板病的疗效机制之一。

Objective To observe the effect of Xiaoyu Zhixue Tablet （XYZXT） on expression of platelet membrane glycoproteins （GP） Ⅰb/Ⅸ/Ⅴ complex and its component GPⅠbα in patients with hemorrhagic thrombopathy, so as to explore its possible mechanism. Methods Ninety-eight patients with hemorrhagic thrombopathy were ran- domly assigned to two groups, the TCM group （68 cases） treated with XYZXT and the Western medicine group （30 cases） treated with adrenosin, vitamins C, K and P, for 6 months totally. The hemostatic effect and the platelet aggregation recovery rate in the two groups were observed. And expressions of GPⅠb/Ⅸ/Ⅴcomplex and GPⅠbα were analyzed by flow cytometry in both groups before and after treatment as well as in 34 healthy persons for control. Resuits The hemostatie effective rate was 89.7% in the TCM group and 46.7% in the Western medicine group （u = 5.68, P 〈0.01 ） ; the platelet aggregation recovery rate in the two groups was 67.6% and 3.3% respectively （X2 = 34. 49, P 〈0. 01 ）. The fluorescence intensity of GPⅠb/Ⅸ/Ⅴ complex and GPⅠbα were lower in both groups before treatment than those of the healthy control （P 〈 0.05 ）, but after treatment the two markers elevated in the TCM group, approaching the control （P 〉 0. 05） , and significantly higher than those in the Western medicine group （P 〈 0. 05）. Conclusion The partial mechanism of XYZXT in treating hemorrhagic thrombopathy might be its regulation on the expression of thrombin receptor at the receptor protein level.