复方丹参滴丸干预短暂性脑缺血发作时对血浆环磷酸腺苷和环磷酸鸟苷的影响

背景在缺血性脑卒中急性期和恢复期皆可见血小板处于活化状态,环磷酸腺苷和环磷酸鸟苷与血小板功能密切相关.目的观察复方丹参滴丸预防治疗短暂性脑缺血发作的临床疗效及对血浆环磷酸腺苷、环磷酸鸟苷的影响.设计随机对照实验.单位滨州医学院附属医院神经科.对象选择2000-09/2001-04滨州医学院附属医院神经科门诊180例自愿参加本实验的短暂性脑缺血发作患者.采用随机数字表将患者按给予复方丹参滴丸剂量大小分为3组.给药10粒/d组60例,男35例,女25例;年龄50～70岁,平均(54.3±7.2)岁;给药20粒/d组60例,男32例,女28例;年龄49～62岁,平均(55.7±5.1)岁.给药30粒/d组60例,男33例,女27例;年龄52～69岁,平均(54.9±5.5)岁.方法给药10粒/d组,1次/d,10粒/次;给药20粒/d组,2次/d,10粒/次;给药30粒/d组,3次/d,10粒/次.患者均在服药4周后,晨抽血3mL,采用放射免疫分析法,测定三组血浆中的环磷酸腺苷、环磷酸尿苷含量.每例患者均3个月随访一次,共随访18个月①观察短暂性脑缺血发作的发作次数及发作形式.②发生缺血性脑卒中例数(包括心、脑卒中).③副作用消化道反应,牙龈出血、鼻出血、皮下出血、口麻、头痛、头晕等.主要观察指标①各组患者短暂性脑缺血发作的发作形式.②各组患者发生缺血性脑卒中例数.③各组患者副作用发生情况.④各组患者血浆中环磷酸腺苷,环磷酸鸟苷水平.结果180例患者均进入结果分析.①发生短暂性脑缺血发作的发作例数给药10粒/d组,发生颈内动脉系统短暂性脑缺血发作的1例;发生椎动脉系统短暂性脑缺血发作的2例;发生脑梗死的1例;发生心肌梗死的2例;给药20粒/d组,分别为2,2,1例;给药30粒/d组,分别为1,2,1例.②发生缺血性脑卒中例数3组分别发生脑卒中的例数为6,5,4例.③各组患者副作用发生情况三组不良事件及副反应分别为1,2,4例,其中给药10粒/d组出现口周麻木1例,给药20粒/d组出现口周麻木和头痛各1例,给药30粒/d组出现胃肠道反应1例,口周麻木2例,头晕1例;未出现牙龈出血、鼻出血及皮下出血病例,同时患者亦未因上述副作用退出治疗.各组比较,无显著性差异(P＞0.05).④各组患者血浆中环磷酸腺苷,环磷酸鸟苷水平3组环磷酸腺苷分别为(2122±3.94),(22.5±3.67),(23.1±7.7)ng/L;环磷酸鸟苷分别为(3.67±1.18),(4.74±2.12),(4.6±0.7)ng/L,(P＞0.05).结论复方丹参滴丸在短暂性脑缺血发作的二级预防中,有肯定的疗效,各剂量比较疗效基本一致,同时无明显副作用.     

复方丹参滴丸干预短暂性脑缺血发作时对血浆环磷酸腺苷和环磷酸鸟苷的影响

背景：在缺血性脑卒中急性期和恢复期皆可见血小板处于活化状态，环磷酸腺苷和环磷酸鸟苷与血小板功能密切相关。目的：观察复方丹参滴丸预防治疗短暂性脑缺血发作的临床疗效及对血浆环磷酸腺苷、环磷酸鸟苷的影响。设计：随机对照实验。单位：滨州医学院附属医院神经科。对象：选择2000-09／2001—04滨州医学院附属医院神经科门诊180例自愿参加本实验的短暂性脑缺血发作患者。采用随机数字表将患者按给予复方丹参滴丸剂量大小分为3组。给药10粒／d组60例，男35例，女25例；年龄50～70岁，平均（54．3&;#177;7．2）岁；给药20粒／d组60例，男32例，女28例；年龄49～62岁，平均（55．7&;#177;5．1）岁。给药30粒／d组60例，男33例，女27例；年龄52&;#177;69岁，平均（54．9&;#177;5．5）岁。方法：给药10粒／d组，1次／d，10粒／次；给药20粒／d组，2次／d，10粒／次；给药30粒／d组，3次／d，10粒／次。患者均在服药4周后，晨抽血3mL，采用放射免疫分析法，测定三组血浆中的环磷酸腺苷、环磷酸尿苷含量。每例患者均3个月随访一次，共随访18个月：①观察短暂性脑缺血发作的发作次数及发作形式。②发生缺血性脑卒中例数（包括心、脑卒中）。（④副作用：消化道反应，牙龈出血、鼻出血、皮下出血、口麻、头痛、头晕等。主要观察指标：①各组患者短暂性脑缺血发作的发作形式。②各组患者发生缺血性脑卒中例数。③各组患者副作用发生情况。④各组患者血浆中环磷酸腺苷，环磷酸鸟苷水平。结果：180例患者均进入结果分析。①发生短暂性脑缺血发作的发作例数：给药10粒／d组，发生颈内动脉系统短暂性脑缺血发作的1例；发生椎动脉系统短暂性脑缺血发作的2例；发生脑梗死的1例；发生心肌梗死的2例；给药20粒／d组，分别为2，2，1例；给药30粒／d组．分别为1，2，1例。②发生缺血性脑卒中例数：3组分别发生脑卒中的例数为6．5，4例。⑨各组患者副作用发生情况：三组不良事件及副反应分别为1．2，4例，其中给药10粒／d组出现口周麻木1例，给药20粒／d组出现口周麻木和头痛各1例，给药30粒／d组出现胃肠道反应1例，口周麻木2例，头晕1例；末出现牙龈出血、鼻出血及皮下出血病例，同时患者亦未因上述副作用退出治疗。各组比较，无显著性差异（P〉0．05）。（少各组患者血浆中环磷酸腺苷，环磷酸鸟背水平：3组环磷酸腺苷分别为（21．22&;#177;3．94），（22．5&;#177;3．67），（23．1&;#177;7．7）ng/L；环磷酸鸟苷分别为（3．67&;#177;1．18）．（4．74&;#177;2．12）．（4．6&;#177;0．7）ng／L，（P〉0．05）．结论：复方丹参滴丸在短暂性脑缺血发作的二级预防中，有肯定的疗效，各剂量比较疗效基本一致，同时无明显副作用。     

Effects of atrial natriuretic factor on cyclic guanosine monophosphate and cyclic adenosine monophosphate accumulation in microdissected nephron segments from rats.

Atrial natriuretic factor (ANF) (1 microM) markedly increased cyclic guanosine monophosphate (cGMP) content in microdissected glomeruli (35-fold) and in microdissected inner medullary collecting ducts (IMCD) (20-fold). ANF caused little or no increase in cGMP content in other nephron segments. The threshold concentration for increased cGMP accumulation by ANF was 0.1-1 nM in IMCD, which is in the range reported for rat plasma. Sodium nitroprusside (1 mM), which selectively stimulates soluble guanylate cyclase, increased cGMP content in glomeruli but not in IMCD. ANF did not alter cAMP accumulation in the absence or presence of vasopressin (AVP) or parathyroid hormone (PTH) in outer and inner medullary tubule suspensions, or in microdissected proximal convoluted tubules (PCT), medullary thick ascending limbs (MAL) or IMCD. These data are compatible with the hypothesis that cGMP is a second messenger for a physiologic action of ANF in the inner medullary collecting duct. ANF apparently activates membrane-bound guanylate cyclase in this segment.     

Arginine vasopressin and cyclic adenosine monophosphate during acute sodium loading in chronic glomerulonephritis

The relationship of arginine vasopressin (AVP) in plasma to cyclic adenosine 3' 5'-monophosphate (cAMP), sodium excretion in urine, and arterial blood pressure were determined during intravenous infusion of hypertonic sodium chloride solution (500 ml of 50 g/l) in 10 normotensive control subjects and in 11 normotensive and 10 hypertensive patients with chronic glomerulonephritis and relatively well preserved kidney function. The concentration of AVP in plasma increased 2-4 fold, osmolality in serum increased 12-16 mosmol/kg, and urinary excretion of cAMP increased 20-40% during sodium loading to the same extent in all three groups. Sodium and water excretion were higher during the sodium loading in the hypertensive patients, but not in the normotensive patients when compared to the control subjects. Neither AVP nor changes in AVP correlated significantly with changes in cAMP excretion, sodium excretion or blood pressure. In the control subjects the level of parathyroid hormone in serum was unchanged during the sodium chloride infusion. Water loading without sodium loading in eight of the control subjects caused a decrease in the excretion of cAMP. In conclusion, the increase in cAMP excretion in urine during the sodium loading might be explained by an AVP-induced stimulation of renal cAMP production. The study does not suggest that AVP plays a role in the increased sodium excretion during sodium loading or in the development of hypertension or chronic glomerulonephritis.     

黄蒲通窍胶囊对血管性痴呆大鼠血浆及脑组织环磷腺苷酸、环磷酸鸟苷和一氧化氮的影响

目的:观察中药黄蒲通窍胶囊对血管性痴呆大鼠血浆及脑组织环磷腺苷酸、环磷酸鸟苷和一氧化氮变化的影响。方法:实验于2004-05在安徽中医学院第一附属医院实验中心进行。选用雄性Wistar大鼠100只,分为空白组15只;假手术组15只;余下70只全部造模,随机选取造模成功大鼠45只,分成模型组、黄蒲通窍组、阿米三嗪3组各15只。空白组不干预,假手术组不阻断大脑中动脉,其他3组线栓法制作大脑中动脉栓塞所致的血管性痴呆大鼠模型。黄蒲通窍组和阿米三嗪组按照大鼠体质量以0.01mL/g的剂量灌胃给药,其他3组予以蒸馏水(0.01mL/g)灌胃,于造模结束第2天开始给药,1次/d,连续处理28d。观察各组大鼠血浆及脑组织环磷腺苷酸、环磷酸鸟苷和一氧化氮的变化。结果:58只大鼠进入结果分析。①环磷腺苷酸:模型组大鼠血浆和脑组织中的环磷腺苷酸浓度降低犤(0.34±0.11),(17.07±2.81)nmol/L犦,黄蒲通窍组、阿米三嗪组较模型组明显升高犤(0.96±0.11),(28.61±6.98),(1.08±0.13),(32.10±6.41)nmol/L犦。②环磷酸鸟苷:模型组大鼠血浆和脑组织中的环磷酸鸟苷浓度升高犤(0.26±0.05),(5.92±1.15)nmol/L犦,黄蒲通窍组、阿米三嗪组较模型组明显降低犤(0.14±0.05),(4.08±0.30),(0.14±0.05),(3.74±0.25)nmol/L犦。③模型组一氧化氮浓     

Virus-induced alterations in cyclic adenosine monophosphate generation in hamster islets of Langerhans.

Inoculation of golden Syrian hamsters with Venezuelan encephalitis (VE) virus results in a sustained diminution in glucose-stimulated insulin release that is correctable by cyclic (c) AMP analogs and phosphodiesterase inhibitors. This suggested the importance of directly measuring cAMP content in VE-infected and control islets in response to insulin secretagogues. The basal cAMP content of VE-infected islets (0.14 +/- 0.02 pmol/micrograms islet DNA) was approximately half that of control islets (0.27 +/- 0.02 pmol/micrograms islet DNA) (P less than 0.05). In the presence of 10 microM glucagon (and 3 mM glucose), the rate of cAMP generation in VE-infected islets was only half that of control islets. With 10 mM alpha-ketoisocaproic acid, the rates of cAMP generation were indistinguishable between control and experimental groups. In response to 20 mM glucose and 3-isobutyl-1-methylxanthine (IBMX) (a phosphodiesterase inhibitor), cAMP generation in VE-infected islets was 81% (NS) of the control rate. When a more specific phosphodiesterase inhibitor, RO 20-1724, was used with 20 mM glucose, cAMP generation in the infected islets was only 44% (P less than 0.001) of the control value. Insulin secretion over the perifusion period paralleled the cAMP levels. In the presence of 10 mM alpha-ketoisocaproic acid, there was no difference in insulin secretion between VE-infected and control islets, while there was a statistically significant (P less than 0.05) difference with 10 microM glucagon or 20 mM glucose (in 1 mM RO 20-1724). These data point to a defect in the cAMP generation system of VE-infected islets, although additional factors involved in insulin secretion may also be impaired by the virus.     

Leukocyte cyclic adenosine monophosphate in asthmatic children. Effects of adrenergic therapy.

Blood specimens for measurement of leukocyte cyclic adenosine monophosphate (AMP) were obtained at weekly intervals from asthmatic children who were participating in a double-blind, crossover study to compare the effects of two adrenergic agents and a placebo. When patients were treated with the placebo, the basal measurements and the cyclic AMP responses of leukocytes to in vitro stimulation with epinephrine (10(-4) M) were similar to those of normal subjects but within one week after initiation of treatment with an adrenergic bronchodilator, leukocyte cyclic AMP responses to adrenergic stimulation in vitro decreased and remained low during the remainder of the treatment period. Within one week after discontinuation of adrenergic therapy, leukocyte cyclic AMP responses returned to the control level. Our results indicate that the alterations in leukocyte cyclic AMP metabolism which have been observed previously in asthmatic patients may result from medications used for treatment of asthma.     

衰老对大鼠阴茎组织中一氧化氮,cGMP,cAMP的影响及与勃起功能障碍的关系

目的:观察衰老对一氧化氮NO,cAMP,cGMP含量变化,探讨其与阴()茎勃起功能障碍的关系。方法:应用亚硝酸还原酶法及放免法对不同月龄,8,16,24个月)大(2鼠阴茎组织中NO及cGMP,cAMP含量分别进行检测。结果:随月龄增加,NO含量先增高,再降低,其中月龄最高,24月龄8最低,各月龄组间差异有非常显著性意义(P<0.001);cGMP,cAMP含量均随月龄增加而逐渐下降,各月龄组间差异也有非常显著性意义(P<0.001)。结论:衰老对NO及cGMP,cAMP有显著影响,提示临床应用增加NO,cGMP,cAMP的药物对勃起功能障碍的康复有重要价值。     

Urinary excretion of adenosine 3'5' monophosphate in vitamin D deficiency.

Urinary cyclic adenosine 3'5' monophosphate (AMP) excretion has been determined by radioimmunoassay in children with rickets and in control children. Cyclic AMP was greatly increased in children with rickets. The excretion of cyclic AMP correlated significantly with parathyroid hormone levels (PTH) and alkaline phosphatase, but not with age, calcaemia and serum inorganic phosphate. Calcium infusion led to a decrease in the excretion of cyclic AMP. The data are consistent with following hypothesis. During vitamin D deficiency, high PTH levels can increase the renal excretion of cyclic AMP. The effects of PTH on bone resorption fail to maintain the levels of serum calcium due to the lack of vitamin D. The mechanism by which the secondary hyperparathyroidism develops during vitamin D deficiency remains to be investigated.     

Pharmacological characterization of rat renal medulla dopamine-sensitive cyclic adenosine monophosphate generating system

The dopamine (DA) DA-1 and DA-2 receptors coupled to 3'-5'-cyclic adenosine monophosphate (cAMP) generating system were characterized in membrane particles of the rat kidney medulla. In confirmation of reports using central and other peripheral tissues, activation of DA-1 receptors with DA, apomorphine or SKF 82526 induced accumulation of cAMP. This effect was blocked by the DA-1 receptors antagonist SCH 23390 and by the other DA-2 receptor antagonists fluphenazine and haloperidol. DA-2 receptor responses coupled negatively to the cAMP generating system were obtained by incubating renal medulla membrane particles with DA or SKF 82526 together with SCH 23390. DA-2 receptor responses were also elicited with the receptor agonists quinpirole and bromocriptine in the absence of SCH 23390. These inhibitory effects on cAMP generation were abolished by the DA-2 receptor antagonist l-sulpiride. Our findings suggest that rat renal medulla contains DA DA-1 and DA-2 receptors similar to those found in brain and in other peripheral tissues. The physiological significance of these receptors, if any, should be established in future studies.     

靶肌肉注射环磷酸腺苷对周围神经再生的作用

目的:观察靶肌肉注射外源性环磷酸腺苷对大鼠坐骨神经再生的治疗作用。方法:实验于2004-10/2005-03在华中科技大学同济医学院协和医院骨科实验室完成。选择健康雄性Wistar大鼠48只,制备大鼠左侧坐骨神经挤压伤模型。实验动物随机数字表法分为3组,每组16只,高剂量组:腓肠肌内注射0.2mL环磷酸腺苷1mg。低剂量组:腓肠肌内注射注射0.2mL环磷酸腺苷0.1mg。对照组:腓肠肌内注射0.2mL生理盐水。术后每日给药1次,共4周。术后4,8周时检测左侧小腿三头肌湿质量。术后8周时检测坐骨神经运动神经传导速度、小腿三头肌复合肌肉动作电位波幅、潜伏期及形态学观察神经再生情况。结果:纳入动物48只,均进入结果分析。①术后4,8周时高剂量组和低剂量组大鼠左小腿三头肌湿质量显著高于对照组[术后4周分别为(1.70±0.58),(1.26±0.71),(0.91±0.24)g;术后8周分别为(2.26±0.62),(1.65±0.16),(1.24±0.37)g],且高剂量组明显高于低剂量组,差异有显著性意义(P<0.01)。②术后8周高剂量组和低剂量组坐骨神经运动神经传导速度、小腿三头肌复合肌肉动作电位波幅、潜伏期及有髓神经纤维计数、髓鞘厚度、轴突直径均高于对照组[运动神经传导速度分别为(33.54±2.65),(26.96±4.12),(19.83±2.74)m/s;复合肌肉动作电位波幅分别为(2.435±1.257),(1.867±0.566),(1.218±0.647)mV;复合肌肉动作电位潜伏期分别为(2.946±0.658),(4.537±0.932),(5.825±1.043)ms;有髓神经纤维计数分别为(1693±201),(1357±185),(876±124)个;髓鞘厚度分别为(1.149±0.138),(0.924±0.086),(0.633±0.105)μm;轴突直径分别为(1.045±0.150),(0.794±0.095),(0.512±0.138)μm],且高剂量组显著高于低剂量组,差异有显著性意义(P<0.01)。结论:靶肌肉注射环磷酸腺苷可促进周围神再生,高剂量环磷酸腺苷对神经再生具有更好的促进作用。     

一氧化氮对腹腔感染脓毒症大鼠心肌细胞第二信使的调节作用

目的:观察大鼠腹腔感染脓毒症时血清一氧化氮(NO)与心肌环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)的关系,探讨NO在地塞米松(Dex)治疗脓毒症中对心肌细胞第二信使的介导作用。方法:健康成熟Wistar大鼠144只,随机取9只为实验前基础值组(0h),余135只随机分成正常对照组、脓毒症组及Dex治疗组。各组于实验后2、4、8、24和48h分别取9只断头取血测定血清NO变化,并取心脏组织,用放射免疫法测定心肌cAMP及cGMP浓度。结果:(1)与对照组比较,脓毒症组血清NO于2h开始显著升高(P<0.01),24h达到高峰,浓度约为0时的12倍;Dex组血清NO于4h开始升高(P<0.05),24h达到高峰(P<0.01),但升高程度低于脓毒症组(P<0.01)。(2)与对照组比较,脓毒症组心肌cAMP、cGMP2h开始升高(P均<0.05),随时间延长逐渐增高,于24h浓度最高(P均<0.01);Dex组心肌cAMP、cGMP于2h显著升高,显著高于脓毒症组(P均<0.01),为基础值的2倍(P均<0.01),此后逐渐下降,至48h接近对照组。结论:腹腔感染脓毒症时大鼠血清NO与心肌cAMP、cGMP浓...     

靶肌肉注射环磷酸腺苷对周围神经再生的作用

目的：观察靶肌肉注射外源性环磷酸腺苷对大鼠坐骨神经再生的治疗作用。 方法：实验于2004-10／2005-03在华中科技大学同济医学院协和医院骨科实验室完成。选择健康雄性Wistar大鼠48只。制备大鼠左侧坐骨神经挤压伤模型。实验动物随机数字表法分为3组，每组16只，高剂量组：腓肠肌内注射0．2mL环磷酸腺苷1mg。低剂量组：腓肠肌内注射注射0．2mL环磷酸腺苷0．1mg。对照组：腓肠肌内注射0．2mL生理盐水。术后每日给药1次，共4周。术后4，8周时检测左侧小腿三头肌湿质量。术后8周时检测坐骨神经运动神经传导速度、小腿三头肌复合肌肉动作电位波幅、潜伏期及形态学观察神经再生情况。 结果：纳入动物48只，均进入结果分析。①术后4，8周时高剂量组和低剂量组大鼠左小腿三头肌湿质量显著高于对照组[术后4周分别为（1．70&;#177;0．58），（1．26&;#177;0．71），（0．91&;#177;0．24）g；术后8周分别为（2．26&;#177;0．62），（1．65&;#177;0．16），（1．24&;#177;0．37）g]，且高剂量组明显高于低剂量组，差异有显著性意义（P〈0．01）。②术后8周高剂量组和低剂量组坐骨神经运动神经传导速度、小腿三头肌复合肌肉动作电位波幅、潜伏期及有髓神经纤维计数、髓鞘厚度、轴突直径均高于对照组[运动神经传导速度分别为（33．54&;#177;2．65），（26．96&;#177;4．12），（19．83&;#177;2．74）m／s；复合肌肉动作电位波幅分别为（2．435&;#177;1．257），（1．867&;#177;0．566），（1．218&;#177;0．647）mV；复合肌肉动作电位潜伏期分别为（2．946&;#177;0．658），（4．537&;#177;0．932），（5．825&;#177;1．043）ms；有髓神经纤维计数分别为（1693&;#177;201），（1357&;#177;185），（876&;#177;124）个；髓鞘厚度分别为（1．149&;#177;0．138），（0．924&;#177;0．086），（0．633&;#177;0．105）min；轴突直径分别为（1．045&;#177;0．150），（0．794&;#177;0．095），（0．512&;#177;0．138）μm]，且高剂量组显著高于低剂量组，差异有显著性意义（P〈0．01）。 结论：靶肌肉注射环磷酸腺苷可促进周围神再生，高剂量环磷酸腺苷对神经再生具有更好的促进作用。     

Effects of glucocorticoid deficiency on renal medullary cyclic adenosine monophosphate of rats.

1. The effects of adrenalectomy on the adenylate cyclase--adenosine 3':5'-cyclic monophosphate (cyclic AMP) system of rat renal medulla were examined to evaluate the mechanism of the impaired water diuresis in glucocorticoid deficiency. 2. Concentrations of cyclic AMP in medullary tubules from adrenalectomized rats were significantly higher than in the tubules from control animals both in the presence and absence of antidiuretic hormone. 3. This abnormality was corrected by the treatment in vivo of the adrenalectomized rats with dexamethasone, but addition of this drug to the incubation medium did not abolish the differences in cyclic AMP between tubules from adrenalectomized and normal rats. 4. The activity of adenylate cyclase or cyclic AMP phosphodiesterase in vitro was not affected by adrenalectomy. 5. In glucocorticoid deficiency, the concentration of cyclic AMP in medullary tubules is increased both with and without antidiuretic hormone. This abnormality may render medullary tubules more permeable to water and may underlie the impaired water diuresis in glucocorticoid deficiency.