葛根素注射液对急性冠状动脉综合征患者冠状血管综合影响的研究

Study of the combined effects of puerarin to patients with coronary artery with acute coronary syndrome

目的:探讨葛根素注射液对急性冠脉综合征(ACS)患者相关内皮损伤、炎症、免疫与细胞因子的影响。方法:将84例ACS按患者随机原则分为常规治疗组(对照组)38例、葛根素注射液组(治疗组)46例;对照组给予常规治疗;治疗组在对照组基础上给予葛根素注射液600mg静脉滴注,两组均治疗20d。观察治疗后血清内皮素(ET)、一氧化氮(NO)、可溶性血管细胞黏附分子-1(sVCAM-1)及可溶性细胞间黏附分子-1(ICAM-1)、氧化低密度脂蛋白(ox-LDL)、基质金属蛋白酶(MMP-9)、可溶性P-选择素、白细胞介素-18(IL-18)含量的变化。结果:①两组治疗后血清ET含量明显低于治疗前(P<0.01),NO含量明显高于治疗前(P<0.01);治疗组sVCAM-1、sICAM-1含量明显低于治疗前(P<0.01),且治疗组血清ET、sVCAM-1、sICAM-1含量降低程度较对照组明显,NO升高程度较对照组明显(P<0.05)。②治疗组白细胞活化显著增加(P<0.05),黏附分子CD11b变化不明显(P>0.05);与对照组相比,治疗组白细胞活化、黏附分子CD11b均有明显变化(P均<0.001)。③两组治疗后血清P-选择素、MMP-9、IL-18含量均显著降低(均P<0.01),且治疗组下降程度较对照组明显(均P<0.05)。两组ox-LDL治疗后无明显变化(P>0.05)。结论:葛根素注射液可能通过多环节影响ACS患者相关内皮损伤、炎症、免疫与细胞因子,改善血管内皮功能,从而达到对血管内皮的保护作用。

Objective： To investigate the effect of Puerarin injection on endothelial injury, inflammation, immune and cytokines in patients with acute coronary syndrome （ACS）. Methods： 84 patients with ACS were randomly divided into two groups： conventional treatment group （control group, n=38） and puerarin injection group （treatment group, n=46）, the control group received conventional therapy; the treatment group received the intravenous infusion ofpuerarin injection （600mg）. Course of the treatment for all patients was 20 days. Then observed the changes of content of serum endothelin （ET）, nitric oxide（NO）, soluble vascular cell adhesion molecule-l（sVCAM-1） and soluble intercellular adhesion molecule-l（slCAM-1）, oxidized low density lipoprotein （ox-LDL）, Matrix Metalloproteinase 9（MMP-9）, soluble P-selectin（Sp-sel） and Interleukin 18（IL-18） after treatment. Results： Oafter 20 days of therapy, the serum level of ET in the two groups was significantly decreased（P〈0.01）. However, the serum level of NO in the two groups was significantly higher than the before treatment（P〈0.01）, and the serum levels of sVCAM-1, slCAM-1 were significantly reduced in the treatment, the serum levels ofET, sVCAM-1, slCAM-1 in the treatment group were obviously lower compared with the control, while the NO increased significantly compared with the control（P〈0.05）. （~Leukocyte activation were significant at the start and the end of the treatment in treatment group （P〈0.05）, while adhesive molecule CD1 lb were not（P〉0.05）. Leukocyte activation and adhesive molecule CD1 lb were all notable after the therapy both in the treatment group and the control group（P〈0.001）. （~）the serum levels of Sp-sel, MMP-9 and IL-18 were all significantly reduced in both group after treatment, and the treatment group decreased obviously compared with the control, there was no change of ox-LDL in serum level after treatment （P〉0.05）. Conclusion： Puerarin injection can improve the function of vascular endothelium in patients with ACS through many ways to regulate endothelial injury, inflammation, immune and cytokines, so as to achieve the protective effect of vascular endothelium.