咪达唑仑对冠心病患者体外血小板活化反应的影响  

Effect of midazolam on platelet activation in patients with coronary heart disease in vitro

作　　者：刘若杉[1] 孙莉[1] 

机构地区：[1]中国医学科学院肿瘤医院肿瘤研究所麻醉科,北京市100021

出　　处：《中华麻醉学杂志》2008年第10期885-888,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价咪达唑仑对冠心病患者体外血小板活化反应的影响。方法分别抽取10名健康志愿者及40例冠心病患者肱静脉血样5ml，抗凝离心后得到富含血小板血浆（PRP）。实验Ⅰ：每份PRP 1 ml，10份健康志愿者PRP作为正常对照组（ⅠC组，n=10），40份冠心病患者PRP随机分为4组（n=10）：ⅠM0组、ⅠM1组、ⅠM2组和ⅠM3组。ⅠC组和ⅠM0组不加入咪达唑仑，ⅠM1组、ⅠM2组、ⅠM3组加入咪达唑仑，其终浓度分别为100、200、400ng／ml，孵育3min，检测血小板聚集率。实验Ⅱ：将剩余PRP进一步离心后得到洗涤血小板（WP），每份WP 1 ml，10份健康志愿者WP作为正常对照组（ⅡC组），40份冠心病患者WP随机分为4组（n=10）：ⅡM0组、ⅡM1组、ⅡM2组和ⅡM3组。ⅡC组和ⅡM0组不加入咪达唑仑，ⅡM1组、ⅡM2组、ⅡM3组加入咪达唑仑，其终浓度分别为100、200、400ng／ml，孵育3min，采用竞争酶联免疫法检测血小板环磷酸腺苷（cAMP）和血栓烷B2（TXB2）的含量。结果与ⅠC组比较，ⅠM0组血小板聚集率升高（P〈0．01）；与ⅠM0组比较，ⅠM2组和ⅠM3组血小板聚集率降低（P〈0．01），ⅠM1组差异无统计学意义（P〉0．05）。与ⅡC组比较，ⅡM0组血小板cAMP含量降低、TXB2含量升高（P〈0．01）；与ⅡM0组比较，ⅡM2组和ⅡM3组血小板cAMP含量升高（P〈0．05或0．01），TXB2含量降低（P〈0．01），ⅡM1组差异无统计学意义（P〉0．05）。结论咪达唑仑200、400ng／ml通过提高血小板cAMP水平，抑制其TXA2生成，可降低冠心病患者血小板的活化程度。Objective To evaluate the effect of midazolam on platelet activation in patients with coronary heart disease （CHD） .Methods Brachial venous blood samples 5 ml drawn from 10 healthy adult volunteers and 40 patients with CHD were anticoagnlated with 3.8% sodium citrate. Platelet rich plasma （PRP） 3 ml was obtained by centrifugation at 800 rpm for 8 min. Experiment Ⅰ： Ten portions of PRP from healthy adult volunteers served as control group with 1 ml for each （group ⅠC, n = 10）. Forty portions of PRP from patients with CHD were randomly divided into 4 groups （n = 10 each）： ⅠM0, ⅠM1, ⅠM2 and ⅠM3. In group ⅠC and ⅠM0, midazolam was not added while in group ⅠM1 , ⅠM2 and ⅠM3, midazolam was added with the final concentration at 100, 200 and 400 ng/ml respectively and the PRPs were then incubated for 3 min. The platelet aggregation rate was determined using turbidimetric method. Experiment Ⅱ ： After the remaining PRP was centrifuged at 2000 r/ min for 5 min, washed platelets （WPs） were obtained. Ten portions of WPs from healthy adult volunteers served as control group with 1 ml for each （group ⅡC, n = 10）. Forty portions of WPs from patients with CHD were randomly divided into 4 groups （ n = 10 each） ： Ⅱ M0, Ⅱ M1 , Ⅱ M2 and ⅡM3 . In group ⅡC and ⅡM0, midazolam was not added while in group Ⅱ M1, ⅡM2 and Ⅱ M3, midazolam was added with the final concentration at 100, 200 and 400 ng/ml respectively and the WPs were then incubated for 3 min. The content of platelet cAMP and TXB2 were measured by enzyme immunoassay. Results Platelet aggregation rate was significantly higher in group Ⅰ M0 than in group ⅠC （P 〈 0.01 ）. Compared with group ⅠM0, platelet aggregation rate was significantly decreased in group ⅠM2 and ⅠM3 （ P 〈 0.01 ） but there was no significant change in group ⅠM1 （ P 〉 0.05）. The content of platelet cAMP was significantly decreased while the level of TXB2 was significantly increased in group Ⅱ M0 as comp

关 键 词：咪达唑仑 冠状动脉硬化 血小板活化 体外研究 

分 类 号：R541.4[医药卫生—心血管疾病] R971.2[医药卫生—内科学]