毛冬青甲素对慢性充血性心力衰竭患者血小板伸展功能的影响

本实验在电镜下观察了毛冬青甲素静注对心力衰竭病人的血小板伸展功能及超微结构的影响.结果显示与正常人相比病人树突型血小板增多(P<0.05);血小板聚集堆亦增多(P<0.01)。应用毛冬青甲素后,树突型血小板及其聚集堆均减少(P<0.01).血小板超微结构:用药前体积增大,形态不规则,有多个伪足突出,管道系统明显扩张,胞浆内未见微管束,用药后体积接近正常,多接近卵圆形,伪足减少并缩短,管道系统扩张情况有所改善,实验从血小板伸展功能及超微结构的角度提示血小板聚集性增高,可能是心衰瘀血证的病理改变之一,而毛冬青甲素能降低血小板聚集性则可能是其抗心衰作用的机制之一.

Effects of Ilexonin A on the UItrastructure and Stretching Function of Platelets in Patients with Chronic Congestive Heart Failure

The ultrastructure and stretching function of the platelets were studied under electron microscope in 5 healthy persons and 11 patients with chronic congestive heart failure (CHF). It was found that in the patients the number of tree-type platelets increased significantly (p<0.05) and the platelet aggregation stacks also increased significantly (p<0.01). But both abnormalities became lessened (p<0.01) after intravenous administration of Ilexonin A (IA). Before treatment, the platelet's ultrastructure of the patients showed that the platelet's volume enlarged, their shape appeared irregular, a number of pseudopods protruded, channel system expanded and no micro-channel bunch appeared in cytoplasm. After intravenous administration of IA, the platelet's volume changed to normal and their shape appeared approximately oval, the pseudopods reduced in number and shortened in length and the expansion of the channel system improved. The result of the study suggests that the significant platelet aggregation is one of the pathologcial changes in CHI patients of blood-stasis type and capacity of IA to reduce the platelet aggregation may be one of the mechanisms against heart failure in patients with CHF.