葛根素对急性冠状动脉综合征患者胰岛素抵抗及纤溶活性的影响

目的:探讨葛根素对急性冠状动脉综合征(ACS)患者胰岛素抵抗(IR)及纤溶活性异常的影响.方法:63例ACS患者分为常规治疗组(30例)和葛根素治疗组(33例).葛根素治疗组于常规治疗基础上加用葛根素500 mg静脉滴注,每日1次,3周为1个疗程.均于治疗前及治疗结束时检测空腹血糖(FBG)、空腹胰岛素(FINS)、纤溶指标,计算胰岛素敏感性指数(ISI);并行静脉闭塞试验(VOT).选择30例健康人作为正常对照组.结果:与正常对照组比较,ACS患者FINS浓度增高,ISI降低,VOT前后组织型纤溶酶原激活物(t-PA)活性降低,纤溶酶原激活物抑制物-1(PAI1)活性升高,P均<0.01.葛根素组治疗后,FINS浓度降低,ISI增高,VOT前后t-PA活性增高,PAI-1活性下降(P<0.05或P<0.01).常规组治疗前及葛根素组治疗后FINS、ISI与PAI-1及VOT后t-PA活性之间呈线性相关(P<0.05或P<0.01).结论:葛根素可改善ACS患者的IR及与IR密切相关的纤溶活性异常.

Effects of puerarin on the insulin resistance and fibrinolytic activity in patients with acute coronary syndrome

Objective: To explore the effect of puerarin on improving the insulin resistance (IR) and abnor mal fibrinolytic activity in patients with acute coronary syndrome (ACS). Methods: Sixtythree patients with ACS were randomly div ided into two groups, 33 in the puerarin treated group and 30 in the routine treated group. In addition to routine therapy, puerarin 500 mg was given to the former by addin g to 250 ml of normal saline for intravenous drip once a day with a therapeu tic course of 3 weeks. The changes of fasting blood glucose (FBG), fasting p lasm a insulin (FINS), tissuetype plasminogen activator (tP A) activity and plasminogen activator inhibitor1 (PAI 1) activity were measured before and after treatment, and the insulin sensit ivity index (ISI) was calculated. At the same time, tPA was measured before and after venous occlusion test (VOT). Besides, 30 healthy subjects were taken as control. Results: In ACS patients, FINS and PAI1 levels were hig her (all P<001) and ISI and tPA before and after VOT were lo wer (all P<001) than those in the healthy controls. FINS and ISI corr elat ed well with fibrinolytic activity abnormality. After puerarin treatment, F INS level lowered and ISI increased significantly, whil e comparing with the routine group, PAI1 activity was lower but tPA activity before and after VOT were higher in the puerarin group (P<005 or P<001). Correlation analysis showed that FINS was p ositively correlated with PAI1 and negatively correlated with tPA after VOT; ISI was negatively correlated with PAI1 and positively correlated wi th t PA activity after VOT in the puerarin group(P<005 or P<0 01). Conclusion: Puerarin could improve the IR and abnormal fibrinolytic activity related with IR in ACS patients.