卡托普利上调缺血性脑卒中患者血小板一氧化氮合酶的实验和临床研究

目的　研究卡托普利对缺血性脑卒中患者血小板一氧化氮合酶 (NOS)的上调及临床应用。方法　测定急性缺血性脑卒中患者及健康体检者的血小板NOS及在体外加氧化低密度脂蛋白 (oxLDL)、卡托普利后血小板NOS的活性 ;检测患者服卡托普利前、服后 1个月及 3个月的血浆oxLDL、NOS、一氧化氮 (NO) ,血小板NOS、NO ,同时检查神经功能。结果　 (1)卒中组和对照组血小板加oxLDL后 ,NOS值均明显下降 (P <0 .0 1) ,卒中组下降更明显 ;(2 )两组血小板同时加卡托普利、oxLDL后 ,NOS值均明显升高 (P <0 .0 1) ,卒中组升高更明显 ;(3)两组血小板单纯加卡托普利后 ,其NOS值均明显升高 (P <0 .0 1) ,同样亦是卒中组升高更明显 ;(4 ) 4 0例缺血性脑卒中患者服用卡托普利后血浆oxLDL明显下降 ,血小板NOS、NO ,血浆NOS、NO明显增高 ,神经功能明显改善。结论　卡托普利有直接上调血小板NOS的作用 ,卡托普利通过提高血小板NOS活性的作用 ,可以改善内皮功能 ,防治脑卒中

Experiment and clinical study of up-regulation effect of captopril on the platelet nitric oxide synthase activity in patients with ischemic stroke

Objective To investigate the up regulation of captopril on the platelet nitric oxide(NO) synthase and clinical application in patients with ischemic stroke.Methods The washed platelets in vitro of the patients with acute ischemic stroke and healthy controls were added with oxidized LDL(oxLDL) and captopril followed by measurement of platelet NO synthase activity.Plasma oxLDL,NO sythase,NO and platelet NO sythase,NO in 40 patients were measured before oral captopril and after oral captropril 1 month,3 months.Results (1)After the washed platelets in vitro were added with oxLDL,the platelet NO synthase activities of the patients and controls were all significantly decreased( P <0.01).(2) After the washed platelets in vitro were added with captopril and oxLDL at the same time,the platelet NO sythase activities of the patients and controls were all significantly increased( P <0.01).(3) After the washed platelets in vitro were only added with captopril, the platelet NO sythase activities of both the patients and controls were all significantly increased( P <0.01).(4) The plasma oxLDL content of 40 patients was significantly decreased and the plasma NO sythase,NO,platelet NO sythase,NO were significantly increased and the neurological function was significantly improved after oral captopril.Conclusion Captopril has directly up regulation effect on the platelet NO sythase activity. These effect can improve the endothelium function and have benefit of the preventment and treatment in the patients with ischemic stroke.