肌氨肽苷对冠心病患者血管内皮功能的影响及其与血小板功能的关系

目的　评价肌氨肽苷注射液对冠心病患者血管内皮功能及血小板功能的影响及二者之间的相互关系。方法　将 14 6例冠心病患者分为肌氨酞苷治疗组与常规治疗组 ,各组又分别分为急性心肌梗死 (AMI)、陈旧性心肌梗死 (OMI)、不稳定型心绞痛 (UA)及稳定型心绞痛 (SA) 4个亚组。对照组 2 0例。分别测定各组治疗前后的血浆内皮素 (ET)、一氧化氮 (NO)及血小板最大聚集率 (PAGTmax)、血栓素B2 (TXB2 )的变化。结果　 1.治疗前 ,各AMI组与UA组的血浆ET、PAGTmax及TXB2 较对照组显著增高 ,NO与对照组比较显著降低 ;OMI及SA组各参数均无显著性差异。 2 .肌氨肽苷治疗后AMI组与UA组的血浆ET、PAGTmax及TXB2 较治疗前显著降低 ,NO呈显著性增高(P <0 .0 5 ,P <0 .0 1) ,与对照组比较差异无显著性 (P >0 .0 5 ) ;ET下降值分别与PAGTmax、TXB2 的变化呈显著性正相关关系。而常规治疗组治疗后各值与治疗前比较虽有变化 ,但均无显著性差异。结论　肌氨肽苷注射液可通过降低血浆ET水平和增加NO浓度来改善血管内皮功能及进一步发挥抑制血小板聚集及血栓形成的作用

Effect of muscular amino acids and nucleosides on vascular endothelial function and its relationship with platelet function in patients with coronary artery disease

Objective To assess the effect of muscular amino acids and nucleosides(MAAN) on vascular endothelial function and platelet aggregation in patients with coronary artery disease (CAD) and relationship between vascular endothelial function and platelet aggregation after MAAN treatment.Methods 146 patients with CAD were divided randomly into trial group and control group.Trail group received MAAN treatment and the control group received routine treatment.The changes of plasma endothelin(ET),nitric oxide(NO),maximum platelet aggregation ratio(PAG Tmax) and thromboxane B 2(TXB 2) were determined before and after trail.Results 1.Before treatment,the plasma ET PAGTmax and TXB 2 in patients with acute myocardial infarction(AMI) and unstable angina(UA) were significantly higher than that in healthy subjects(P<0.01) and plasma NO was significantly Lower than that in healthy subjects(P<0.05).They were not different between the patients with old myocardial infarction(OMI) and stable angina(SA)(P>0.05).2.There were significantly difference of levels of plasma ET,NO,PAG Tmax and TXB 2 between before and after MAAN treatment in patients with AMI and UA.After treatment of MAAN,there were positive significantly correlation between plasmas ET and PAGTmax,TXB 2 in AMI and UA(P<0.05).In control group,there were no significant differences of these parameters between before and after treatment.Conclusion MAAN not only improve vascular endothelial function by reducing level of plasma ET and increasing concentration of plasma NO but also play an important role in preventing platelet aggregation and thrombosis.