通心络胶囊对急性冠状动脉综合征患者介入治疗后不同时期血小板活化及血管内皮功能的影响

 目的 探讨通心络胶囊对冠状动脉介入治疗不同时期血小板活化状态和内皮功能的影响。方法 160例急性冠状动脉综合征（ACS）患者随机分为通心络胶囊治疗组（通心络组，80例）和常规治疗组（常规组，80例），健康对照组50例，分别检测血浆血小板活化因子CD62p、CD63和GPⅡb/Ⅲa水平，测定反映血管内皮功能的血浆血管性假血友病因子（vWF），ET-1和NO， 并测量内皮依赖性血管舒张功能（FMD）。服用通心络胶囊治疗2个月和6个月后分别复查上述指标并进行治疗前后比较及两组间比较。结果 ACS患者血小板活化指标CD62p、CD63及GPⅡb/Ⅲa较健康对照组显著升高（P<0.01），vWF因子和ET-1显著升高（P<0.01），NO和FMD显著降低（P<0.01）。冠脉介入术后CD62p、CD63和GPⅡb/Ⅲa以及vWF因子较术前升高（均P<0.05），FMD降低（P<0.05），ET-1和NO差异无统计学意义（P>0.05）。常规组和通心络组分别治疗2个月和6个月后， CD62p、CD63、GPⅡb/Ⅲa及vWF因子、ET-1均较治疗前显著下降（P<0.05，P<0.01）、NO和FMD增加（P<0.05，P<0.01）。与常规治疗组相比，通心络组更明显降低CD62p、CD63、GPⅡb/Ⅲa、vWF因子以及ET-1的水平（P<0.05，P<0.01），明显增加NO和FMD的水平（均P<0.01），而且治疗6个月时较治疗2个月时以上指标变化更明显（P<0.05，P<0.01）。结论 通心络胶囊可用于冠状动脉介入治疗后预防和治疗冠脉内血栓及保护血管内皮功能。

Effects of Tongxinluo Capsule on Platelet Activity and Vascular Endothelium Function at Different Stages in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

OBJECTIVE To observe the effects of Tongxinluo capsule on platelet activity and function of vascular endothelium at different stages after percutaneous coronary intervention(PCI) in patients with acute coronary syndrome.METHODS One hundred and sixty patients with acute coronary syndrome were randomly divided into Tongxinluo(TXL) treatment group(TXL group,80 patients) and conventional treatment group(conventional group,80 patients).Fifty healthy people were enrolled as control group.The blood levels of CD62p,CD63,glucose protein(GP)Ⅱb/Ⅲa and endothelium 1(ET-1),vWF,nitric oxide(NO),and flow-mediated dilatation(FMD) in brachial artery were examined before PCI and the second day after PCI in both groups.Then the patients in TXL group received TXL treatment for 6 months(4 capsule tid),and the above parameters were compared with those of conventional treatment group.RESULTS The ACS patients′ blood levels ofCD62p,CD63,GPⅡb/Ⅲa,vWF and ET-1 increased significantly(P<0.01),NO and FMD decreased significantly(P<0.01),compared with control group.The ACS patients′ plasma levels of vWF increased significantly(P<0.05),CD62p,CD63,GPⅡb/Ⅲa and FMD decreased significantly(P<0.05) after PCI compared with baseline levels.In both TXL group and conventional group,the patients′ plasma levels of CD62p,CD63,GPⅡb/Ⅲa,vWF and ET-1 decreased significantly(P<0.05,P<0.01),FMD increased significantly(P<0.05,P<0.01) compared with baseline levels,meanwhile there were significant differences in all the parameters between TXL group and conventional group(P<0.01,P<0.05).In addition,the parameters showed significant differences between 6 months and 2 months after TXL treatment(P<0.01,P<0.05).CONCLUSION TXL can inhibit platelet activity and protect the vascular endothelium function after PCI.