中西医结合学报
中西醫結閤學報
중서의결합학보
JOURNAL OF CHINESE INTEGRATIVE MDEICINE
2011年
1期
38-48
,共11页
黄明伟%王欢%钟文娟%吴小盈%陈慧
黃明偉%王歡%鐘文娟%吳小盈%陳慧
황명위%왕환%종문연%오소영%진혜
脑心通%中成药%冠状动脉血栓形成%血小板聚集抑制剂%炎症趋化因子类%动物实验%大鼠
腦心通%中成藥%冠狀動脈血栓形成%血小闆聚集抑製劑%炎癥趨化因子類%動物實驗%大鼠
뇌심통%중성약%관상동맥혈전형성%혈소판취집억제제%염증추화인자류%동물실험%대서
Naoxintong%Chinese patent drugs%coronary thrombosis%platelet aggregation inhibitors%chemokines%animal experimentation%rats
目的:探讨脑心通胶囊(Naoxintong capsule,NXT)联合双联抗血小板疗法(dual antiplatelet therapy,DA)对大鼠自体冠状动脉微栓塞(coronary microembolization,CME)的治疗效果.方法:在夹闭升主动脉的同时自心尖部注入同源大鼠微血栓(大鼠自体血凝块经38 μm的滤网过滤制成)建立CME模型.95只大鼠不均等随机分成6组,即空白组(n=10)、假手术组(n=10)、CME组(n=15)、NXT组(n=15)、DA组(n=30)、NXT联合DA组(NDA组,n=15).各组术前预给药3 d,术后继续用药7 d,取血后处死动物收集标本.共计69只大鼠获得完整数据.苏木精-伊红染色观察CME数量百分比(CME%),剪尾法检测出血时间(bleeding time,BT),玻片法检测凝血时间(clotting time,CT),比浊法检测二磷酸腺苷诱导的最大血小板聚集率(platelet aggregation rate,PAR),自动血液分析仪检测血小板计数,酶联免疫吸附试验法检测P选择素、白细胞介素6(interleukin-6,IL-6)、IL-10、内皮素l(endothelin-1,ET-1)及内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS).结果:与空白组及假手术组比较,CME组的CME%、PAR、P选择素、IL-6和ET-1明显升高(P＜0.01),BT、CT、IL-10和eNOS明显降低(P＜0.01);与CME组比较,各药物处理组的BT、CT、IL-10和eNOS明显升高(P＜0.05或P＜0.01),CME%、PAR、P选择素、IL-6和ET-1明显降低(P＜0.05或P＜0.01);其中DA组的BT和CT最长,PAR和P选择素最低,而NDA组的IL-10和eNOS最高,CME%、IL-6和ET-1最低;血小板计数在各组中无统计学差异(P＞0.05).结论:脑心通胶囊联合双联抗血小板治疗可能通过抑制血小板聚集、调节促炎因子与抗炎因子以及ET-1与eNOS的平衡显著减少CME模型大鼠的CME%.脑心通胶囊联合双联抗血小板治疗还能够减少双联抗血小板治疗出血的危险性.
目的:探討腦心通膠囊(Naoxintong capsule,NXT)聯閤雙聯抗血小闆療法(dual antiplatelet therapy,DA)對大鼠自體冠狀動脈微栓塞(coronary microembolization,CME)的治療效果.方法:在夾閉升主動脈的同時自心尖部註入同源大鼠微血栓(大鼠自體血凝塊經38 μm的濾網過濾製成)建立CME模型.95隻大鼠不均等隨機分成6組,即空白組(n=10)、假手術組(n=10)、CME組(n=15)、NXT組(n=15)、DA組(n=30)、NXT聯閤DA組(NDA組,n=15).各組術前預給藥3 d,術後繼續用藥7 d,取血後處死動物收集標本.共計69隻大鼠穫得完整數據.囌木精-伊紅染色觀察CME數量百分比(CME%),剪尾法檢測齣血時間(bleeding time,BT),玻片法檢測凝血時間(clotting time,CT),比濁法檢測二燐痠腺苷誘導的最大血小闆聚集率(platelet aggregation rate,PAR),自動血液分析儀檢測血小闆計數,酶聯免疫吸附試驗法檢測P選擇素、白細胞介素6(interleukin-6,IL-6)、IL-10、內皮素l(endothelin-1,ET-1)及內皮型一氧化氮閤酶(endothelial nitric oxide synthase,eNOS).結果:與空白組及假手術組比較,CME組的CME%、PAR、P選擇素、IL-6和ET-1明顯升高(P＜0.01),BT、CT、IL-10和eNOS明顯降低(P＜0.01);與CME組比較,各藥物處理組的BT、CT、IL-10和eNOS明顯升高(P＜0.05或P＜0.01),CME%、PAR、P選擇素、IL-6和ET-1明顯降低(P＜0.05或P＜0.01);其中DA組的BT和CT最長,PAR和P選擇素最低,而NDA組的IL-10和eNOS最高,CME%、IL-6和ET-1最低;血小闆計數在各組中無統計學差異(P＞0.05).結論:腦心通膠囊聯閤雙聯抗血小闆治療可能通過抑製血小闆聚集、調節促炎因子與抗炎因子以及ET-1與eNOS的平衡顯著減少CME模型大鼠的CME%.腦心通膠囊聯閤雙聯抗血小闆治療還能夠減少雙聯抗血小闆治療齣血的危險性.
목적:탐토뇌심통효낭(Naoxintong capsule,NXT)연합쌍련항혈소판요법(dual antiplatelet therapy,DA)대대서자체관상동맥미전새(coronary microembolization,CME)적치료효과.방법:재협폐승주동맥적동시자심첨부주입동원대서미혈전(대서자체혈응괴경38 μm적려망과려제성)건립CME모형.95지대서불균등수궤분성6조,즉공백조(n=10)、가수술조(n=10)、CME조(n=15)、NXT조(n=15)、DA조(n=30)、NXT연합DA조(NDA조,n=15).각조술전예급약3 d,술후계속용약7 d,취혈후처사동물수집표본.공계69지대서획득완정수거.소목정-이홍염색관찰CME수량백분비(CME%),전미법검측출혈시간(bleeding time,BT),파편법검측응혈시간(clotting time,CT),비탁법검측이린산선감유도적최대혈소판취집솔(platelet aggregation rate,PAR),자동혈액분석의검측혈소판계수,매련면역흡부시험법검측P선택소、백세포개소6(interleukin-6,IL-6)、IL-10、내피소l(endothelin-1,ET-1)급내피형일양화담합매(endothelial nitric oxide synthase,eNOS).결과:여공백조급가수술조비교,CME조적CME%、PAR、P선택소、IL-6화ET-1명현승고(P＜0.01),BT、CT、IL-10화eNOS명현강저(P＜0.01);여CME조비교,각약물처리조적BT、CT、IL-10화eNOS명현승고(P＜0.05혹P＜0.01),CME%、PAR、P선택소、IL-6화ET-1명현강저(P＜0.05혹P＜0.01);기중DA조적BT화CT최장,PAR화P선택소최저,이NDA조적IL-10화eNOS최고,CME%、IL-6화ET-1최저;혈소판계수재각조중무통계학차이(P＞0.05).결론:뇌심통효낭연합쌍련항혈소판치료가능통과억제혈소판취집、조절촉염인자여항염인자이급ET-1여eNOS적평형현저감소CME모형대서적CME%.뇌심통효낭연합쌍련항혈소판치료환능구감소쌍련항혈소판치료출혈적위험성.
Obiective:In lhe present study,the efficacy of Naoxintong capsule(NXT),a compound Chinese herbal medicime,combined with dual antiplatelet therapy(DA)in a rat model of coronary microembolization(CME) was evaluated.Methods:CME in rats was developed by injecting a suspension of microthrombotic particles into the left ventricle when the ascending aorta was obstructed.Microthrombotic particles were generated from lhe clots of rats sized by filtration through a screen(apertu re diameter,38 μm).A total of 95 rats were randomly divided into six groups,including control group,sham-operation(sham)group,CME model(CME)group,and NXT,DA,and NDA(NXT Plus DA)groups.Rats in treatment groups were administered intragastrically with NXT,DA,and NDA,respectively,from 3 d before to 7 d after operation.All rats were sacrificed on day 7 post-operationally,and samples of blood and heart were collected.The complete data of 69 rats were obtained.The incidence of CME(CME%)was evaluated by hematoxylin-eosin staining.Bleeding time(BT)and clottina time(CT)were measured by means of tail cutting and glass slide methods,respectively.Adenosine diphosphate-induced maximum platelet aggregation rate(PAR)was assessed with turbidimetry.Platelet counts were examined by an automated hematology analyzer.The Ievels of serum P-selectin,interleukin(IL)-6,IL-10,endotheIin(ET-1)and endotheliaI nitric oxide synthase(eNOS)were all detected by enzymelinked immunosorbent assay.Results:Compared with controI and sham groups,CME group had an increase in CME%,PAR,P-selectin,IL-6 and ET-1(P＜0.01,P＜0.01),and a decrease in BT,CT,IL-10 and eNOS (P＜0.01,P＜0.01);compared with CME group,the groups receiving medications had an increase in BT,CT,IL-10 and eNOS(P＜0.05 or P＜0.01),and a decrease in CME%,PAR,p-selectin,IL-6 and ET-1(P＜0.05 or P＜0.01),with DA group increasing most in BT and CT and decreasing most in PAR and P-selectin,and With NDA group increasing most in IL-10 and eNOS and decreasing most in CME%,IL-6 and ET-1.In terms of platelet counts,there was no statisticaIly significant difference among groups(P>0.05).Conclusion:NXT combined with DA can decrease CME%.The probable mechanism is that this therapy can appropriately inhibit platelet aggregation,balance the pro-and anti-inflammatory cytokines as well as serum ET-1 and eNOS.This therapy can also reduce risk of intraoperative bleeding during DA therapy.
