葛根素对不稳定心绞痛患者血小板颗粒膜蛋白、溶酶体膜蛋白及血浆纤溶酶原激活物抑制物、C反应蛋白的影响

目的：探讨血小板表面活性蛋白血小板颗粒膜蛋白（CD63），溶酶体膜蛋白（CD62P），血浆纤溶酶原激活物抑制物（PAI－1）及C－反应蛋白（C－RP）在不稳定心绞痛（UAP）发生，发展中的作用，用葛根素对不稳定心绞痛患者CD63，CD62P，PAI－1及C－RP的影响。方法：59例UAP患者随机分成葛根素组（32例）及抵克力得组（27例），并对照观察治疗4周前后血小板CD63，CD62P及血浆PAI－1，C－RP水平的变化。结果：（1）与健康人及稳定性心绞痛（SAP）对照组比较，UAP患者血小板CD63，CD62P及血浆API－1，C－RP水平明显升高（P＜0．05，P＜0．01），随着不稳定心绞痛Braunwald分组的加重，血小板CD63，CD62P及血浆PAI－1，C－RP水平亦增加；（2）治疗4周后，葛根素组及抵克力得组CD63，CD62P，PAI－1及C－RP测定值分别显著低于治疗前水平（P＜0．05，P＜0．01），而治疗后两组间上述各指标水平比较差异无显著性。结论：血小板活化 ，纤溶机制异常及炎症反应物这三者在UAP发生及发展过程中起着重要的作用。葛根素抗血小板活化，纤溶活性及减轻炎症反主尖的突出作用对预防急性冠状动脉综合征的发生和发展有机其重要的临床意义。

Effect of Puerarin on Platelet Activating Factors CD63 and CD62P, Plasminogen Activator Inhibitor and C-reactive Protein in Patients with Unstable Angina Pectoris

OBJECTIVE: To explore the action of platelet surface activity protein (platelet granule membrane protein CD63 and lysosome membrane protein CD62P), plasminogen activator inhibitor (PAI-1) and C-reactive protein (C-RP) in occurrence and development of unstable angina pectoris (UAP), and the effect of Puerarin on them. METHODS: Patients with UAP were randomly divided into the treated group (32 cases, treated with Puerarin) and the control group (27 cases, treated with Ticlid), the therapeutic course was 4 weeks for both groups. Changes of CD63, CD62P, PAI-1 and C-RP before and after treatment were observed. RESULTS: The levels of CD63, CD62P, PAI-1 and C-RP were higher in UAP patients than those in normal subjects and in the patients with stable angina pectoris (P < 0.05 or P < 0.01). These parameters were increased along with the aggravating of patients in Braunwald's degree. After 4-week treatment, the above-mentioned parameters lowered in both groups (P < 0.05 or P < 0.01), and comparison between the two groups showed no significant difference statistically. CONCLUSION: Platelet activation, plasminogen activator and C-RP play important roles in the occurrence and development of UAP. The obvious effect of Puerarin in anti-platelet activation, improving plasminogen activator and relieving inflammatory reaction was of great importance in preventing the occurrence and development of acute coronary syndrome clinically.