通心络联合阿托伐他汀、阿司匹林对家兔动脉粥样硬化早期血管外膜炎症因子表达的干预

目的:探讨通心络联合阿托伐他汀、阿司匹林对家兔动脉粥样硬化早期颈动脉外膜炎症因子表达的影响。方法:高脂饮食复合单侧颈总动脉硅胶管包裹制备兔动脉粥样硬化早期模型。72只新西兰兔随机分为对照组(control)、模型组(model)、通心络(tongxinluo)组、阿托伐他汀(atorvastatin)组、阿司匹林(aspirin)组和三药联用(three-drug combination)组。每组各12只。对照组给予普通饲料,模型组及各用药组家兔均实施单侧颈动脉硅胶管包裹术复合高脂饲料喂养,通心络组给予通心络超微粉混悬液(0.3 g·kg-1·d-1)灌胃,阿托伐他汀组给予阿托伐他汀(2.5 mg·kg-1·d-1)灌胃,阿司匹林组给予阿司匹林(12 mg·kg-1·d-1)灌胃,三药联用组给予通心络超微粉混悬液(0.3 g·kg-1·d-1)、阿托伐他汀(2.5 mg·kg-1·d-1)和阿司匹林(12.5 mg·kg-1·d-1)灌胃,连续给药,4周后取材。HE染色判定颈动脉内中膜病理形态变化;生化法检测血脂变化;ELISA法测定各组家兔颈动脉包裹段外膜单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1β(IL-1β)和IL-10表达水平;免疫组化法检测血管外膜IL-8表达水平。结果:模型组与对照组比较,血清总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDLC)的水平明显增高。除阿司匹林组外,各用药组TC、TG和LDL-C的水平与模型组比较明显降低。三药联用组较其它用药组TC、TG和LDL-C的水平明显降低。模型组颈动脉外膜中MCP-1和IL-1β的表达明显高于对照组,IL-10的表达减弱。与模型组比较,各用药组颈动脉外膜中MCP-1和IL-1β的表达减弱,IL-10的表达增强。三药联用组较其它各用药组MCP-1和IL-1β的表达明显减弱,IL-10的表达明显增强。各用药组颈动脉外膜IL-8表达减少。结论:通心络、阿托伐他汀和阿司匹林三药联用可通过降脂、调节血管外膜炎症反应而有效延缓动脉粥样硬化进程,且较单药应用作用更佳。

Interventional effects of tongxinluo combined with atorvastatin and aspi-rin on adventitial inflammation in early stage of atherosclerosis

AIM: To investigate the effect of a treatment proposal, which consisted of tongxinluo, atorvastatin and aspirin, on adventitial inflammation of early atherosclerosis in rabbit carotid artery. METHODS: The atherosclerotic model was established in the rabbits with silicone collar, which was positioned around the carotid arterial adventitia+high-cholesterol diet. New Zealand rabbits (n=72) were randomly divided into 6 groups (n=12): control group, model group, tongxinluo group, atorvastatin group, aspirin group, and three-drug combination group. The rabbits in control group were fed with common foodstuffs, and the rabbits in all the other groups were fixed the right carotid arteries with the silicone tube, and were fed with fatty foodstuffs. The rabbits in tongxinluo group, atorvastatin group and aspirin group were given the suspension of tongxinluo supermicropowder (0.3 g·kg^-1·d^-1), atorvastatin (2.5 mg·kg^-1·d^-1) and aspirin (12 mg·kg^-1·d^-1) respectively,and the rabbits in three-drug combination group were given the suspension of tongxinluo supermicropowder (0.3 g·kg^-1·d^-1), atorvastatin (2.5 mg·kg^-1·d^-1) and aspirin (12 mg·kg^-1·d^-1) together. The rabbits in each group were fed with the corresponding medicines for 4 weeks. The tissue slices of carotid artery were observed under light microscope with HE staining. The change of blood lipid was detected by biochemical assay. The protein levels of MCP-1, IL-1β and IL-10 in the carotid arterial adventitia were detected by ELISA. The immunohistochemical staining was used to detect the protein expression of IL-8 around the carotid arterial adventitia.RESULTS: Compared with control group, the contents of TC, TG and LDL-C were significantly increased, and the content of IL-10 was significantly decreased in model group. The levels of TC, TG and LDL-C were significantly decreased in tongxinluo group and atorvastatin group compared with model group, no significant difference between tongxinluo group and atorvastatin group was observed. In the three-drug combination group, the levels of TC, TG and LDL-C were lower than those in atorvastatin group and tongxinluo group. Compared with control group, the contents of MCP-1 and IL-1β were significantly increased, and the content of IL-10 was significantly decreased in model group. Compared with model group, the contents of MCP-1 and IL-1β were decreased in tongxinluo group, atorvastatin group and aspirin group, no significant difference between the 3 groups was observed. The content of IL-10 was decreased in three-drug combination group, and the contents of TC, TG and LDL-C were lower than those in tongxinluo group, atorvastatin group and aspirin group. The content of IL-8 was decreased in tongxinluo group, atorvastatin group, aspirin group and three-drug combination group.CONCLUSION: The strategy of three-drug combination enhances the effect of regulating the lipid metabolism and inhibiting the adventitia inflammation. It plays an important role to intervene in the process of atherosclerosis.