内皮素、一氧化氮等内皮细胞活性因子与动脉硬化闭塞症血瘀证关系的研究

Relationship between Endothelins, Nitric Oxide and Other Endothelial Active Factors and Blood Stasis Syndrome in Patients with Atherosclerosis Obliterans

目的：观察动脉硬化闭塞症（ＡＳＯ）血瘀证患者血浆内皮素（ＥＴ）、一氧化氮（ＮＯ）、细胞粘附分子等内皮细胞活性因子水平及其变化规律，借以从血管内皮细胞角度，从蛋白、分子水平探讨ＡＳＯ血瘀证的实质。方法：选择９８例本病患者，按轻、中、重三组和气滞血瘀、气虚血瘀和湿热血瘀三种证型；利用密度梯度法检测外周循环血内皮细胞计数（ＣＥＣ），利用放射免疫测定法和亚硝酸盐比色法检测ＥＴ、ＮＯ等血浆活性因子，利用酶联免疫法测定血浆细胞间粘附分子，同时检测血液流变学指标。结果：本病患者均存在高ＣＥＣ、高ＥＴ和低ＮＯ血症，存在血粘度增加等血液流变学变化。结论：血管内皮细胞损伤及由此引起的血液流变学变化是ＡＳＯ血瘀证的发生机制之一；检测ＥＴ、ＮＯ等血浆活性因子有助于判断病情轻重，协助辨证分型。

Objective: To observe the levels of plasma endothelin (ET), nitric oxide (NO), intercellular adhesion molecule (ICAM) and other endothelial active factors, and to investigate the nature of atherosclerosis obliterans (ASO) blood stasis Syndrome (BSS) from the point of vascular endothelia and molecules. Methods: Ninety eight patients with ASO BSS were divided into 3 groups (mild, moderate and severe) and 3 clinical Syndrome subtypes (Qi stagnation BSS, Qi deficiency BSS and Damp Heat BSS). The circulating endothelial count (CEC), ET, NO and other plasma active factors were determined by density gradient method, radioimmunoassay, enzyme immunoassay method. Results: The patients with ASO BSS had high CEC and ET levels, low levels of NO, and had alterations of hemorheology, particularly in those with severe BSS and Damp Heat BSS. Conclusion: ASO BSS patients have endothelial injuries, endothelial dysfunction, and alterations of hemorheology, which may be the pathogenetic mechanism of ASO BSS. Observation on these parameter changes will be helpful to evaluate severity, to distinguish the clinical types in TCM, and to clarify the nature of BSS.