丹参多酚酸盐对急性心肌梗死PCI术后CD14^+单核细胞活性氧和Toll样受体的影响

The effects of Danshen duofensuanyan on CD14^+ monocyte peroxidation injury and Toll-like-receptor4 in patients with acute myocardial infarction after PCI

目的:观察丹参多酚酸盐对急性心肌梗死经皮冠状动脉介入术(PCI)术后,外周血单核细胞脂质过氧化损伤、单核细胞趋化因子-1及Toll样受体的影响,以进一步探讨丹参多酚在拮抗急性心肌梗死单核细胞氧化损伤中的作用。方法:选取我院2011年2月至2012年8月,因急性ST段抬高性心肌梗死入院患者320例,所有患者均行急诊PCI治疗。将320例患者随机分为常规治疗组(155例)和丹参多酚治疗组(165例)。常规治疗组予以阿司匹林、氯吡格雷及阿托伐他汀等药物口服。而丹参多酚治疗组除上述治疗外,予以丹参多酚注射液400mg静点,此后每日1次,持续7d。入院时及治疗7d末取静脉血6 mL分离单核细胞,通过流式细胞仪、ELISA等方法检测单核细胞活性氧ROS、血浆单核细胞趋化因子-1(MCP-1)以及单核细胞Toll受体4(TLR4)表达的变化。另取30例自愿者为对照组。结果:治疗7d末,两组患者单核细胞ROS、血浆MCP-1及TLR4水平均较入院前明显降低(P<0.01),而与常规治疗组比较,治疗7d末丹参多酚治疗组单核细胞ROS、血浆MCP-1及TLR4水平显著降低(P<0.05)。结论:注射用丹参多酚能通过抑制CD14+单核细胞TLR4信号转导途径,抑制单核细胞过氧化损伤,降低急性心肌梗死PCI术后患者单核细胞引起的炎性损伤。

Objective：To observe the effect of zhusheyong danshen duofensuanyan on peripheral blood mononuclear cells lipid peroxidation injury,monocyte chemoattractant protein-1 and Toll-like-receptor4 in patients with acute myocardial infarction after percutaneous coronary intervention,and explore its possible mechanism.Methods ：We choosed 320 patients with ST Segment elavation acute myocardial infarction from Feb.2011 to Aug.2012 in Anzhen Hospital,and all the patients received percutaneous coronary intervention treatment.All the patients were randomly divided into two groups： conventional treatment group（n=155） and danshen duofen treatment group（n=165）.The conventional treatment group was administered with aspirin,clopidogrel,atorvastatin calcium,and the Danshen Duofen treatment group was intravenously administered with danshen duofensuanyan 400mg once 1 d for 7 d besides Aspirin,clopidogrel,atorvastatin calcium.Before admission and 7 d later,6ml venous blood was obtained from all the patients,and monocytes were separated.The level of monocytes reactive oxygen species（ROS）,monocyte chemoattractant protein-1（MCP-1）,monocytes Toll-like receptor 4（TLP4） were investigated by durchflusszytometrie and ELISA.And blood samples of 30 healthy volunteers were determined.Results： 7days later,the level of monocytes ROS,MCP-1 and TLR4 of two groups decreased significantly compared with pre-admission（P0.01）.Compared with convetional treatment group,the level of monocytes ROS,MCP-1 and TLR4 of Danshen Duofen treatment group were inclined signifancantly（P0.05）.Conclusion： Danshen duofensuanyan can suppress lipid peroxidation injury of monocytes through inhibiting Toll-like-receptor4 signal pathway,and decreased inflammatory response in patents with ST-elavation acute myocardial infarction after PCI.