丹参多酚酸盐对重度慢性阻塞性肺疾病急性加重期患者血小板和内皮细胞功能的影响

Effect of depsides salts from salvia miitiorrhiza on functions of platelet and vascular endothelial cell of patients with chronic obstructive pulmonary disease in acute exacerbation stage

目的探讨丹参多酚酸盐（DsM）对重度慢性阻塞性肺疾病急性加重期（AEc0PD）患者血小板和血管内皮细胞功能变化的影响。方法将40例中重度AECOPD患者按随机数字表法分为常规治疗组、DSM组，每组20例；并选择同期20例健康者作为健康对照组。两组常规治疗相同；DSM组每日加用DSM0．2g静脉滴注，连用2周。应用酶联免疫吸附法检测血浆膜糖蛋白140（GMP140）和血管性血友病因子（vMF），应用流式细胞术检测血小板膜糖蛋白P一选择素／血小板质膜蛋白（cD62P／cD61）表达双阳性血小板百分率。结果两个治疗组治疗前GMPl40[常规治疗组（17．51士2．75）pg／L，DSM组（16．94±2．57）μg／L3、vMF水平[常规治疗组（13．64±2．37）μg／L，DSM组（14．14±2．17）μg／L3及CD62P／CD61双阳性血小板百分率[常规治疗组（20．24±2．64）％，DsM组（19．54±2．69）％]较健康对照组[（9．25±1．80）μg／L、（6．13±1．17）μg／L、（11．21±1．11）％]均显著上升（均P〈0．01）；治疗后两组GMP140、vMF水平及CD62P／CD61双阳性血小板百分率显著降低，且DSM组的下降幅度[GMP140（3．91±0．57）μg／L，vWF（3．86土0．71）μg／L，CD62P／CD61（3．69±0．62）％]较常规治疗组[GMPl40（2．30±0．33）μg／L，vWF（2．72±0．45）μg／L，CD62P／CD61（2．24±0．45）％]更为显著（均P〈0．01），但是均高于正常水平。结论DSM有显著抑制血管内皮细胞和血小板活化的作用，可预防血栓性疾病。

Objective To investigate the influence of depsides salts from salvia miltiorrhiza （DSM） on the functions of platelet and vascular endothelial cell in severe chronic obstructive pulmonary diseases （COPD） patients with acute exacerbation. Methods Forty patients with severe COPD in acute exacerbation stage were randomly divided into two groups： conventional treatment （CT） group and DSM treatment （DSM） group, each consisting of 20 cases, and 20 healthy adults served as control group. All COPD patients were given conventional treatment, while for the patients in DSM group 0. 2 g depsides DSM was given through intravenous drip everyday in addition for 2 weeks. The levels of the plasma platelet membrane glycoprotein 140 （GMP140） and von Willebrand factor （vMF） in the blood samples were determined with enzyme linked immunosorbent assay （ELISA） and the level of CD62P/CD61 with flow cytometry （FCM）. Results The level of GMP140 （CT group： （17.51±2.75） μg/L, DSM group： （16.94±2.57） μg/L], vMF [CT group： （13.64 ± 2.37） μg/L, DSM group.. （14.14± 2.17） μg/L3 and CD62P/CD61 CCT group： （20. 24 ± 2.64） %, DSM group ： （19.54 ± 2.69） % ] were elevated significantly in severe COPD patients with acute exacerbation compared to the control group before treatment [ （11.21 ±1.11）%, （9.25 ± 1.80） μg/L, （6.13±1.17） μg/L, all P〈 0. 013. After intervention, the levels of the above three indexes in both treatment groups were significantly decreased, and the decrease in DSM group [GMP140： （3.91 ± 0. 57） μg/L, vWF： （3.86±0.71） μg/L, CD62P/CD61： （3.69±0. 62）%3 was more prominent than the CT group [GMP140： （2.30±0.33） μg/L, vWF： （2.72±0.45） μg/L, CD62P/CD61： （2.24±0.45）%, all P〈 0. 01], but they were higher than normal levels. Conclusion DSM has the effect of inhibiting the activation of vascular endothelial cells and platelet. The medicine may be used to prevent thrombotic diseases.