通心络胶囊对不稳定型心绞痛患者血管内皮功能的影响

Effect of Tongxinluo Capsule on Function of Vascular Endothelium in Patients with Unstable Angina Pectoris

目的 :探讨通心络胶囊 (下称通心络 )对不稳定型心绞痛 (unstableanginapectoris ,UAP)患者血管内皮功能的影响。方法 :4 6例UAP患者 ,随机分为常规组 (采用西医常规治疗 )和通心络组 (采用西医常规加通心络治疗 ) ,观察治疗前和治疗 2个月后血清内皮素 (ET)、一氧化氮 (NO)、血管性假血友病因子 (VonWillebrandfactor,vWF)、可溶性血管细胞粘附分子 1(sVCAM 1)、可溶性细胞间粘附分子 1(sICAM 1)的变化 ,并应用多普勒超声诊断仪测定肱动脉血流介导的血管扩张 (flow mediateddilatation ,FMD)变化率。结果 :与治疗前比较 ,治疗后两组患者血清vWF、ET水平均明显下降 (P <0 0 1) ,NO水平和FMD均升高 (P<0 0 5或P <0 0 1) ;通心络组血清sVCAM 1和sICAM 1水平显著下降 (P <0 0 1) ,而常规组血清sV CAM 1和sICAM 1水平无明显变化 (P >0 0 5 )。治疗后通心络组血清vWF、ET、sVCAM 1和sICAM 1水平均低于常规组 (P <0 0 1) ,NO水平和FMD高于常规组 (P <0 0 1)。结论 :通心络可能通过降低血清ET、vWF和部分细胞粘附分子水平 ,提高NO水平等途径改善血管内皮功能 ,提高临床疗效。

Objective:To evaluate the effect of Tongxinluo (TXL) Capsule on function of vascular endothelium in patients with unstable angina pectoris (UAP). Methods:Forty-six UAP patients were randomly divided into two group, the 28 patients in the treated group treated by conventional therapy plus TXL and the 18 patients in the control group treated by conventional therapy alone. Changes of blood levels of endothelin (ET), nitric oxide (NO), Von Willebrand factor (vWF), soluble vascular cell adhesive molecule-1 (sVCAM-1) and soluble intracellular adhesive molecule-1 (sICAM-1) from before treatment to after two months of treatment were observed, and the flow-mediated dilatation (FMD) in brachial artery was detected at the same time using ultrasonography. Results:After treatment, the blood level of vWF and ET obviously decreased (P<0 01), levels of NO and FMD increased (P<0 05 or P<0 01) in both groups. Levels of sVCAM-1 and sICAM-1 significantly decreased in the treated group (P<0 01), while in the control group, no marked change was found in sVCAM-1 and sICAM-1 (P>0 05). Compared with the control group after treatment, the levels of vWF, ET, sVCAM-1 and sICAM-1 in the treated group were lower (P<0 01), and levels of NO and FMD were higher (P<0 01). Conclusion:TXL might protect vascular endothelium, improve clinical therapeutic effect by path of decreasing blood levels of ET, vWF and partial cellular adhesive factor, and increasing the level of NO.