葛根素对不稳定型心绞痛病人胰岛素抵抗及纤溶活性的影响

EFFECT OF PUERARIN ON THE INSULIN RESISTANCE AND FIBRINOLYTIC ACTIVITY IN PATIENTS WITH UNSTABLE ANGINA

①目的 探讨葛根素对不稳定型心绞痛 (UA)病人胰岛素抵抗 (IR)及纤溶活性异常的影响。②方法6 9例UA病人随机分为常规治疗组 (31例 )和葛根素治疗组 (38例 ,于常规治疗基础上加用葛根素治疗 ) ,均于治疗前及治疗结束时检测血糖、血浆胰岛素 (FINS)、纤溶指标 ,计算胰岛素敏感性指数 (ISI)。选择 30例健康人作为对照组。③结果 与对照组比较 ,UA组FINS浓度增高 ,ISI降低 ,组织型纤溶酶原激活物 (tPA)活性降低 ,纤溶酶原激活物抑制物 1(PAI 1)活性升高 (t=2 .139～ 3.2 0 7,P <0 .0 5 ,0 .0 1)。葛根素组治疗后 ,FINS浓度降低 ,ISI增高 ,tPA活性增高 ,PAI 1活性下降 (t=2 .116～ 3.6 36 ,P <0 .0 5 ,0 .0 1)。UA组治疗前及葛根素组治疗后FINS ,ISI与PAI 1之间存在高度线性相关 (r =0 .35 1,- 0 .332 ,0 .4 2 7,- 0 .4 5 2 ,P <0 .0 1)。④结论 葛根素可改善UA病人的IR及与IR密切相关的纤溶活性异常。

Objective\ To investigate the effects of puerarin on insulin resistance(IR) and abnormal fibrinolytic activity in patients with unstable angina pectoris(UA). \ Methods\ Sixty nine patients with UA were randomly divided into two groups, 31 in the conventional group and 38 in the puerarin group. In the puerarin group, puerarin was given in addition to regular therapy. The fasting blood glucose, plasma insulin, tissue plasminogen activator(tPA) and plasminogen activator inhibitor 1(PAI 1) activity were measured before and after the treatment and insulin sensitivity index(ISI) was calculated. 30 healthy subjects were taken as the controls.\ Results\ The concentration of plasma insulin increased and ISI fell down. The activity of PAI 1 depressed and tPA increased in UA group compared with the normal controls( t=2.139-3.207, P <0.05,0.01). After puerarin treatment, the concentration of plasma insulin decreased, ISI increased, the activity of tPA increased and PAI 1 decreased( t= 2.116- 3.636, P < 0.05 ,0.01). Plasma insulin and ISI correlated remarkably with PAI 1 in UA group before treatment and puerarin group after treatment( r=0.351, -0.332, 0.427, -0.452, P <0.01).\ Conclusion\ Puerarin may improve IR and IR related abnormal fibrinolytic activity in UA patients.