川芎嗪对急性冠脉综合征患者介入术后血小板活化及血管内皮功能的影响

目的探讨川芎嗪对冠脉介入治疗术后血小板活化状态及内皮功能的影响。方法80例急性冠脉综合征（ACS）患者随机分为川芎嗪治疗组（简称川芎嗪组，40例）和常规治疗组（简称常规组，40例），两组病例在冠脉介入术前和术后次日采用流式细胞仪检测血小板活化指标CD62p、CD63及糖蛋白（GP）Ⅱb／Ⅲa受体复合物的表达水平；用双抗体夹心固相酶联免疫吸附试验（ELISA）测定血浆假血友病因子（vWF）的表达水平；用放射免疫测定法测定血浆内皮素1（ET-1）的表达水平；用酶法测定血浆一氧化氮（NO）的含量；用彩色多谱勒超声诊断仪测量内皮依赖性血管舒张（FMD）功能。静脉滴注川芎嗪治疗14天后复查上述指标并进行比较。结果与健康对照组比较，ACS患者术前CD62p、CD63、GPⅡb／Ⅲa受体复合物、vWF及ET-1均显著升高（P〈0．01），FMD和NO显著降低（P〈0．01）。冠脉介入术后血小板活化有升高趋势，而vWF因子升高（P〈0．05），FMD降低（P〈0．05），但ET-1和NO水平差异无统计学意义（P〉0．05）。与常规组比较，川芎嗪组CD62p、CD63、vWF、ET-1及GPⅡb／Ⅲa的水平明显降低（P〈0．05，P〈0．01），FMD水平增加（P〈0．05）。结论川芎嗪可用于冠状动脉介入术前、后预防和治疗冠脉内血栓及保护血管内皮功能。

Effect of Tetramethylpyrazine on Platelet Activation and Vascular Endothelial Function in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

OBJECTIVE: To explore the effect of tetramethylpyrazine (TMP) on platelet activation and vascular endothelial function after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). METHODS: Eighty patients with ACS were assigned to the TMP group (40 patients) and the control group (40 patients). Before and at the next day of PCI, patient's expressions of the indices of platelet activation CD62p, CD63 and glucose protein (GP) II b/III a were tested by flow cytometry, von Willebrand (vWF) by ELISA, endothelin-1 (ET-1) by RIA, and plasma content of nitrogen oxide (NO) were determined by enzyme reaction, at the same time, the flow-mediated dilatation (FMD) in brachial artery was measured as well using color Doppler. All the afore mentioned indexes were reexamined for comparing when patients in the TMP group received TMP treatment for 14 days. RESULTS: Before PCI blood levels of CD62p, CD63, GP II b/III a, vWF and ET-1 expression increased significantly (all P < 0.01), FMD and NO decreased significantly (P < 0.01) in ACS patients, as compared with those in the healthy control. After PCI, level of vWF increased significantly (P < 0.05), FMD decreased significantly (P < 0.05), while CD62p, CD63, GP II b/III a, ET-1 and NO changed insignificantly (P > 0.05). As compared with the control group, levels of CD62p, CD63, GP II b/III a, vWF and ET-1 decreased significantly (P < 0.05 or P < 0.01), FMD increased significantly (P < 0.05) in the TMP group. CONCLUSION: TMP can be useful for preventing and treating the intra-coronary thrombosis and protect the vascular endothelial function in patients undergoing PCI.