血府逐瘀浓缩丸抗血小板活化的临床疗效与体外血清药理作用的相关性研究

目的：探讨血小板活化在不稳定性心绞痛（unstable angina pectoris,UA)和急性心肌梗死（acute myocardial infarction,AMI)中的意义以及血府逐瘀浓缩丸抗血小板活化的临床疗效及其体外血清药理作用的相关性。方法：采用流式细胞技术和特异性标记抗体，检测口服血府逐瘀浓缩丸前后UA患者全血血小板膜糖蛋白CD62P和CD41／45的表达，并以UA患者的含药血清与AMI模型小鼠的外周血体外共温育后，检测大鼠CD62P水平。结果：UA患者CD62P及CD41／45表达量增高，分别为（24．36±7．91）％和（29．51±12．21）％，经有效治疗后降至（19．57±7．22）％（与治疗前比较，P＜0．05）和（20．87±8．73）％；同时血小板粘附和聚集率增高。AMI大鼠CD62P为（39．73±12．36）％，与有效病例的含药血清后降至论（30．41±10．36）％（与温育前比较，P＜0．05），而疗效不佳患者的药后血清干预作用则较差（P＞0．05）。结论：UA患者和AMI大鼠的血小板活化增强。血府逐瘀浓缩丸含药血清药理与临床整体药效在抑制血小板活化作用上的一致性，反映出中药血清药理作用与临床整体药效的良好相关性。

Study on Relationship of Clinical Effect of Xuefu Zhuyu Concentrated Pill and Serum Pharmacological Anti-Platelet Activating Effect in Vitro

OBJECTIVE: To assess the significance of platelet activation in unstable angina pectoris (UA) and acute myocardial infarction (AMI), and to explore the relationship of clinical effect of Xuefu Zhuyu concentrated pill (XCP) in vivo and the serum pharmacological anti-platelet activating effect of XCP in vitro. METHODS: By flow cytometry and special labelled antibodys to detect the whole blood platelet membranous glycoprotein CD62P and CD41/45 expressions in UA patients before and after XCP treatment, as well as those in peripheral blood of AMI rats before and after co-cultured with XCP containing serum from patients at 37 degrees C for 30 min. RESULTS: CD62P and CD41/45 expressions increased significantly in UA patients to 24.36 +/- 7.91% and 29.51 +/- 12.21% respectively. After effective treatment, they decreased to 19.57 +/- 7.22% and 20.87 +/- 8.73% respectively accompanied with increase of platelet adhesion and aggregation rate. The difference of CD62P before and after treatment was significant (P < 0.05). CD62P in blood of AMI rats was 39.73 +/- 12.36%, after being co-cultured with XCP containing serum from patients treated effectively, it reduced to 30.41 +/- 10.36% (P < 0.05), but after co-cultured with the serum from patients treated ineffectively, it showed less intervention effect (P > 0.05). CONCLUSION: Platelet was highly activated in UA patients and AMI rats. The consistency between clinical holistic effect of XCP and serum pharmacological effect of XCP in platelet activation inhibition reflects a good correlation between serum pharmacological effect of Chinese herbal medicine and its clinical holistic effect.