参麦注射液对肺心病急性加重期患者PAC-1和CD62p表达的影响

Influence of Shenmai injections on expression of PAC-1 and CD62p in patients with acute serious chronic pulmonary heart disease

目的通过检测肺心病急性加重期患者在应用参麦注射液治疗前、后血小板PAC-1(血小板激活复合物-1)和CD62p(p-选择素)表达水平的变化,观察参麦注射液的临床疗效,并探讨其在肺心病急性加重期治疗过程中可能的新的作用机制。方法将入选的60例肺心病患者随机分为治疗组和对照组,两组均作常规治疗,治疗组在此基础上加用参麦注射液。并分别于治疗前、后采静脉血,应用流式细胞仪检测比较两组全血活化血小板标记物PAC-1和CD62p水平的变化。同时观察两组患者的临床疗效及治疗前后血液流变学的变化。结果治疗组加用参麦注射液治疗后患者血小板PAC-1和CD62p的阳性百分率分别从(72.63±5.62)%和(52.81±7.42)%下降为(58.42±5.49)%和(42.19±5.46)%,差异具有高度的统计学意义;而对照组未见上述变化。同时对临床疗效观察发现治疗组和对照组的总有效率分别为80.0%和63.3%,差异有统计学意义(P<0.05);且治疗组对血液流变学的影响明显优于对照组(P<0.05)。结论参麦注射液可显著提高肺心病急性加重期患者的临床疗效,其作用机制可能与抑制肺心病患者外周血小板表面PAC-1和CD62p表达,降低血小板活性有关。

Objective By detecting the difference of expression level on PAC-1 and CD62p before and after the treatment of Shenmai injections in the patients with acute serious chronic pulmonary heart disease,the clinical therapeutic effect and possible role of the Shenmai injections in the treatment of the chronic pulmonary heart disease are studied and analyzed. Methods All of 60 patients with acute serious chronic pulmonary heart disease were randomly divided into treatment group and control group. Conventional treatment was taken for both of them,while the treatment group had additional application of Shenmai injections. By collecting venous blood samples before and after the treatment,positive rates of PAC-I and CD62p were measured using the flow cytometry, and the difference of them were compared between two groups. Meanwhile, the clinical therapeutic effect of two groups and the difference of the blood rheology before and after the treatment were also observed. Results The positive expression rate of PAC-1 and CD62p of the patients in treatment group declined from （72.63±5.62）% and （52.81±7.42）% to （58.42±5.49）% and （42.19±5.46）%, with significant statistical differences; while the control group had no above changes. The total effective rate of the treatment group and control group were found as 80.0% and 63.3% separately,with significant differences （P〈0.05）, and the influence of the blood rheology in treatment group was significantly higher in the control group （P〈0.05）. Conclusion The Shenmai injections can significantly improve the clinical therapeutic effect of the patients with acute serious chronic pulmonary heart disease,the mechanism of action can be in relation with reducing the expression of PAC-I and CD62p,and inhibiting the olatelet activity.