疏血通对慢性阻塞性肺疾病合并肺动脉高压患者凝血状态及血清NO、NOS水平的影响

目的 观察疏血通治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)的疗效及对患者凝血状态及血清NO、NOS水平的影响.方法 将80例COPD合并PAH患者随机分为对照组和观察组,每组40例.对照组给予常规综合治疗,观察组在对照组基础上加用疏血通注射液治疗.分别于治疗前后检测患者血清一氧化氮(N0)、一氧化氮合成酶(NOS)、内皮素-1(ET-1)、抵抗素水平及血红蛋白(HB)、全血高切、低切黏度,比较两组治疗前后肺动脉收缩压、血气指标、肺功能指标及症状、体征改善情况.结果 治疗前,观察组与对照组各项测定指标差异均无统计学意义;治疗后,观察组较对照组血清NOS、NO水平明显升高(P＜0.05),ET、抵抗素水平明显降低(P＜0.05);全血高切黏度、全血低切黏度及HB水平明显降低(P＜0.05);肺动脉收缩压明显降低(P＜0.05),血气指标(PaO2、PaCO2、SaO2)、肺功能指标(FEV1、FEV1/FVC)及咳嗽、喘息、紫绀等症状、体征评分明显改善(P＜0.05).结论 疏血通辅助治疗COPD合并PAH,可通过调节血清NO、ET-1平衡,降低血清抵抗素水平,改善血管内皮功能,缓解血液高凝状态,降低肺动脉压,从而明显改善患者血气指标、肺功能指标及临床症状、体征.

Effect of Shuxuetong on Blood Coagulation and Levels of Serum NO and NOS in Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Arterial Hypertension

Objective To observe the curative effect of Shuxuetong in the treatment of chronic obstructive pulmonary disease(COPD) complicated with pulmonary arterial hypertension(PAH) and its effect on blood coagulation,levels of serum nitric oxide (NO) and nitric oxide synthetase (NOS).Methods 80 cases of patients with COPD complicated with PAH were randomly divided into the control group and the observation group,40 cases in each group.Both groups were given routine comprehensive treatment and the observation group were additionally treated with Shuxuetong injection.Levels of serum NO,NOS,endothelin-1 (ET-1),resistin,hemoglobin (HB),whole blood high shear viscosity and whole blood low shear viscosity were detected before and after treatment.The pulmonary arterial systolic blood pressure,blood gas indexes,pulmonary function indexes and relief of symptoms and signs were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences between the two groups in the indexes.After treatment,in the observation group,levels of NOS and NO were significantly higher than those in the control group,while levels of ET and resistin,the whole blood high shear viscosity,whole blood low shear viscosity,HB level and pulmonary arterial systolic pressure were significantly lower than those in the control group (P ＜ 0.05).The blood gas indexes (PaO2,PaCO2,SaO2),pulmonary function indexes (FEV1,FEV1/FVC) and scores of symptoms and signs such as cough,wheezing and cyanosis were significantly better than those in the control group(P ＜ 0.05).Conclusion The application of Shuxuetong in the treatment of COPD complicated with PAH can reduce the serum resistin level,improve endothelial function,relieve hypercoagulable state and reduce pulmonary artery pressure by regulating the levels of serum NO and ET-1 balance,thereby significantly improving the blood gas indexes,pulmonary function indexes and clinical symptoms and signs.