新型体外反搏对冠心病患者血清PGI2,t-PA,TXB2,AngⅡ的影响

Effect of Enhanced External Counterpulsation on Serum PGI_2,t-PA,TXB_2 and AngⅡin Patients with Coronary Heart Disease

目的观察新型体外反搏(EECP)对冠心病患者血清前列环素(Prostacyclin PGI2),组织型纤溶酶原激活物(t-PA),血栓素B2(TXB2),血管紧张素Ⅱ(angio tensinⅡ,AngⅡ)的影响,探讨EECP治疗冠心病的机制。方法收集100例冠心病患者(体外反搏组52例,单纯药物组48例)治疗前后外周静脉血清,两组均予常规药物治疗,体外反搏组每天给予60 min体外反搏,每周五次,二周为一疗程。采用酶联免疫吸附法(ELISA)检测测定各血清中PGI2,t-PA,TXB2,AngⅡ的水平,并进行各组分析比较PGI2,t-PA,TXB2,AngⅡ的水平。结果经过单纯2周药物治疗和联合新型体外反搏治疗后,较治疗前相比,冠心病患者外周血清中PGI2,t-PA,TXB2,AngⅡ水平:在体外反搏组TXB2,AngⅡ含量明显降低(P<0.05),PGI2,t-PA含量明显升高(P<0.05);而在药物治疗组,PGI2,t-PA,TXB2,AngⅡ含量虽有变化,但均无明显变化(P>0.05)。结论冠心病患者呈血管内皮功能失调,纤溶系统功能降低。新型体外反搏可降低TXB2,AngⅡ的产生,并促进PGI2,t-PA的释放,减轻脂质过氧化反应,稳定易损斑块,对血管内皮有保护作用,这是新型体外反搏为临床上治疗冠心病的提供了新途径。

Objective To investigate the effect of enhanced external counterpulsation （ EECP） on serum PGI2、t-PA、TXB 2 and AngⅡin patients with coronary heart disease （ CHD） and its mechanism.Methods The serum PGI 2、t-PA、TXB 2 and AngⅡlevels of 100 cases of CHD were tested.Patients were divided into EECP group （52 cases） and medication group （48 cases）.The serum concentrations of PGI 2、t-PA、TXB2 and AngⅡof each group before and after treatment were compared for the correlation analysis.Results After 2 weeks medication treatment or EECP treatment , compared withthe levels before treatment , the serum levels in CHD patients EECP group were as follows.PGI2 and t-PA increased significantly （ P＆lt;0.05 ） , TXB2 and AngⅡ decreased significantly （ P＆lt;0.05 ）.Conclusions Coronary heart disease patients with vascular endothelial dysfunction , fibrinolytic function decreased.Enhanced external counter-pulsation can reduce the TXB 2 and AngⅡproduction , and promote the release of PGI 2 and t-PA, reduce lipid peroxi-dation, stabilizing the vulnerable plaque , and has a protective effect on endothelial cells , which may be one of the mech-anisms of enhanced external counterpulsation therapy of coronary heart disease in clinic .