蚓激酶对冠心病患者血管活性物质的影响及意义

目的 :观察蚓激酶对冠心病的疗效及对血管活性物质和血液流变学的影响。方法 :对 48例冠心病心绞痛患者随机分成 2组 ,对照组 (n =2 3) ,予硝酸异山梨酯 10mg ,tid ;治疗组 (n =2 5 ) ,予硝酸异山梨酯 10mg 蚓激酶胶囊 40 0mg ,tid ,疗程 4wk。观察治疗前后心绞痛发作次数、硝酸甘油消耗量、ECGST T改变、血浆血小板表面α颗粒膜蛋白 140 (GMP 140 )、血栓烷素B2 (TXB2 )、5 羟色胺 (5 HT)水平、血液流变学参数变化。结果 :心绞痛发作时血浆GMP 140 ,TXB2 和 5 HT水平均高于健康对照组 (P <0 0 1) ,发作控制后各项值显著下降 ;经治疗后 ,2组心绞痛发作次数、硝酸甘油消耗量和血浆GMP 140 ,TXB2 ,5 HT水平、血液流变学参数均明显下降 (P <0 0 5～ 0 0 1) ,治疗组优于对照组 (P <0 0 1)。结论 :血浆GMP 140 ,TXB2 和 5 HT水平变化在冠心病发生发展中有重要作用 ,硝酸异山梨酯和蚓激酶联合通过对冠心病患者的血管活性物质的调节 ,从而改善临床症状的作用

Effect and significance of lumbrokinase on vasoactive substances in patients with coronary artery disease

AIM: To evaluate the effects of lumbrokinase on patients with coronary heart disease (CHD) and its effects on plasma levels of alpha-granule membrane protein-140 (GMP-140), thromboxane B 2 (TXB 2), 5-hydroxy-tryptamine (5-HT), parameters of blood rheology. METHODS: Forty-eight patients with angina pectoris were randomly divided into control group (n=23, isosorbide dinitrate 10 mg, tid) and treatment group (n=25, isosorbide dinitrate and lumbrokinase capsules 400 mg, tid) for 4 wk. Before and after treatment, attack of angina pectoris, nitroglycerin consumption, change of electrocardiogram ST-T were performed, including plasma GMP-140, TXB 2, 5-HT and blood rheology. RESULTS: The plasma levels of GMP-140, TXB 2, 5-HT was higher in CHD group than that of healthy control group (P<0.01). After control of attacks of angina pectoris, the plasma levels of GMP-140, TXB 2 and 5-HT were significantly decreased (P<0.01). After the treatment of attacks of angina pectoris nitroglycerin consumption, plasma levels of GMP-140, TXB 2, 5-HT and parameters of blood rheology were reduced in 2 groups, which was more remarkable in treatment group than in control group (P<0.01). CONCLUSION: Plasma levels of GMP-140, TXB 2 and 5-HT may play an important roles in sustaining and developing of CHD. Combined isosorbide dinitrate with lumbrokinase have an vital role in improving clinic symptoms by means of the regulation of plasma levels vasoactive substances in the patients with CHD.