普乐林注射液对不稳定型心绞痛患者组织型纤溶酶原激活剂及其抑制物的影响

The effect of “pu le lin” injection on plasma tissue plasminogen activator and plasminogen activator inhibitor of patients with unstable angina pectoris

目的：探讨普乐林注射液（主要成分为葛根素）对冠心病患者组织型纤溶酶原激活剂（ｔＰＡ）及其抑制物（ＰＡＩ）的影响和临床意义。方法：不稳定型心绞痛（ＵＡＰ）患者２８例静滴普乐林注射液６００ｍｇ，每日１次，疗程１４日；患者均经冠状动脉造影证实；并于治疗前后接受平板运动试验及血浆ｔＰＡ、ＰＡＩ和血脂水平检测。结果：ＵＡＰ患者血浆ｔＰＡ水平显著低于对照组，而ＰＡＩ则显著高于对照组（Ｐ均＜０．０１）；治疗后ｔＰＡ水平由治疗前（１．４９±０．１８）×１０３Ｕ／Ｌ升至（１．６８±０．２４）×１０３Ｕ／Ｌ（Ｐ＜０．０５），而ＰＡＩ由（８．４０±２．１０）×１０３ＡＵ／Ｌ降至（６．７５±１．３３）×１０３ＡＵ／Ｌ（Ｐ＜０．０１），高密度脂蛋白胆固醇由（０．８７±０．１２）ｍｍｏｌ／Ｌ升至（１．０６±０．２８）ｍｍｏｌ／Ｌ，Ｐ＜０．０５；载脂蛋白Ｂ１００由（１．１６±０．２６）ｇ／Ｌ降至（１．０５±０．２４）ｇ／Ｌ，Ｐ＜０．０５；临床总有效率８２．１％；１６例复查冠状动脉造影患者中１３例冠脉附壁血栓消失或明显减小；治疗后ΣＳＴ显著减小；运动耐量提高（Ｐ＜０．０５）。结论：普乐林注射液对不稳定型心绞痛患者有较好临床疗效，并能减少心?

Objective:To study the effect of “pu le lin” injection on plasma tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI) of patients with unstable angina pectoris(UAP).Methods:Twentyeight cases of UAP were given with “pu le lin” injection 600 mg intravenously per day and 14 days as 1 therapy course.All patients were received selective coronary angiography (SCA) and flat style movement treadmill test,plasma tPA and PAI were measured by spectrophotometry,while the serum apolipoproteinA1(apoAⅠ)、apolipoproteinB100(apoB100) and high density lipoproteincholeserol(HDLC) were tested respectively before and after treatment.Results:The plasma tPA level of UAP patients was significantly lower than that of the control group,and PAI was significantly higher than that of the control group (all P<001).The tPA was increased from (149±018)×103 U/L to (168±024)×103 U/L after treatment (P<005),and PAI decreased from (840±210)×103 AU/L to (675±133)×103 AU/L (P<001).The concentration of apoAⅠ and HDLC were obviously increased (all P<005),while the apoB100 was lowed after treatment (P<005),13 cases were observed that thrombi disappeared or diminished by SCA after treatment.The clinical total effective rate was 821%,and the average ΣST during exercise testing was also significantly decreased after treatment.Conclusions:A better therapeutic effect of “pu le lin” injection for UAP patients is observed,including decreased myocardial ischemia during exercise test,which is probablely contributed by the mechanisms of regulating tPA and PAI levels and its antiplatelet thrombogenesis.