丹参多酚酸盐对急性心肌梗死PCI术后患者血管内皮和血小板活化功能的影响

目的：观察丹参多酚酸盐对急性心肌梗死PCI术后血浆丙二醛（MDA）、一氧化氮（NO）、内皮素（ET-1）和血小板糖蛋白CD63、CD62p的影响，以进一步探讨丹参多酚酸盐在保护急性心肌梗死患者血管内皮细胞免受损伤和抑制血小板激活的作用。方法选取该院2011年2月-2012年8月因急性ST段抬高性心肌梗死入院患者320例，所有患者均行急诊PCI治疗。将320例患者随机分为常规治疗组（155例）和丹参多酚治疗组（165例）。常规治疗组予以阿司匹林、氯吡格雷及阿托伐他汀等药物口服。而丹参多酚治疗组除上述治疗外，予以注射用丹参多酚400 mg静点，此后一天一次，持续7 d。入院时及治疗7 d末取静脉血6 mL分离血浆和血小板，通过生物化学、ELASA、流式细胞仪等方法检测血浆MDA、NO、ET-1和血小板糖蛋白CD63、CD62p的变化。结果治疗7 d末，两组患者血浆MDA、ET-1水平均较入院前明显降低（P〈0.01）；血浆NO水平显著升高（P〈0.01）；血小板糖蛋白CD63、CD62p水平较入院前显著降低（P〈0.01）；而与常规治疗组比，治疗7 d末丹参多酚治疗组，血浆MDA、ET-1水平和血小板糖蛋白CD63、CD62p水平均明显降低（P〈0.05）。血浆NO水平明显升高（P〈0.05）。结论注射用丹参多酚能保护急性心肌梗死患者血管内皮细胞，抑制血小板活化，对急性心肌梗死的治疗起到积极的作用。

Effects of Danshen Duofensuanyan on vascular endothelial cells and platelet activation with acute myocardial infarction after PCI

Objective To observe the effect of Zhusheyong Danshen Duofensuanyan on plasma malondialdehyde,nitric oxide,endothe-lin-1 and platelet glycoprotein CD63,CD62p in patients with acute myocardial infarction after percutaneous coronary intervention,and to explore its possible effects in protecting vascular endothelial cells from damage and inhibiting platelet activation effect of acute myocar-dial infarction. Methods We chose 320 patients with ST segment elavation acute myocardial infarction from February 2011 to August 2012 in Anzhen Hospital,and all the patients received percutaneous coronary intervention treatment. All the patients were randomly di-vided into two groups：conventional treatment group （n=155） and Danshen Duofen treatment group （n=165）. The conventional treat-ment group was administered with aspirin,clopidogrel,atorvastatin calcium,and the Danshen Duofen treatment group was intravenously administered with Danshen Duofensuanyan 400 mg once a day for 7 days besides aspirin,clopidogrel,atorvastatin calcium. Before admis-sion and 7 days later,6 mL venous blood was obtained from all the patients,and plasma and platelet were separated. The level of plasma MDA,NO,ET-1 and platelet glycoprotein CD63,CD62p were investigated by biochemistry,flow cytometry and ELISA. Results Seven days later,the level of plasma MDA,ET-1 and platelet glycoprotein CD63,CD62p decreased significantly compared with pre-admission （P〈0. 01）,and the level of NO increased（P〈0. 01）. Compared with conventional treatment group,the level of plasma MDA,ET-1 and platelet glycoprotein CD63,CD62p of Danshen Duofen treatment group were declined significantly（P〈0. 05）. And the level of NO of Danshen Duofen treatment group was increased（P〈0. 05）. Conclusions Danshen Duofensuanyan can protect vascular endothelial cells against damage,and inhibit platelet activation in patients with acute myocardial infarction,and has played a positive role in treating acute myocardial infarction.