益气活血法对老年人不稳定型心绞痛经皮冠状动脉介入术后血小板聚集抑制率和血小板膜糖蛋白的影响  

Effects of supplementing qi and activating blood circulation on platelet inhibition rate and platelet membrane glycoprotein in elderly patients with unstable angina pectoris undergoing percutaneous coronary intervention

作　　者：张萍[1] 张虹[1] 毛静远[2] 

机构地区：[1]天津市南开医院心血管科,300100 [2] 天津市中医药大学第一附属医院心血管科

出　　处：《中华老年医学杂志》2014年第5期473-476,共4页Chinese Journal of Geriatrics

基　　金：教育部“创新团队发展计划”

摘　　要：目的 探讨益气活血法对老年人不稳定型心绞痛经皮冠状动脉介入术（PCI）后血小板聚集抑制率和血小板膜糖蛋白的影响. 方法 将老年不稳定型心绞痛（气虚血瘀证）患者177例随机分为观察组90例和对照组87例,观察组在西药常规治疗的基础上给予益气活血法中药治疗,两组均治疗14d,治疗前和治疗14d后测定血小板聚集抑制率和血小板膜糖蛋白. 结果 观察组治疗14d后,花生四烯酸（AA）、二磷酸腺苷（ADP）诱导的血小板聚集抑制率均升高,与治疗前及对照组治疗后比较,差异均有统计学意义（均P＜0.01）.观察组阿司匹林、氯吡格雷抵抗发生率低于对照组（8.9％比21.8％,11.1％比25.3％,均P＜0.05）.观察组治疗14d后,血小板α-颗粒膜蛋白、溶酶体完整膜蛋白、纤维蛋白原受体表达率下降,与治疗前及对照组治疗后比较,差异均有统计学意义（均P＜0.01）. 结论 益气活血法可有效地抑制老年不稳定型心绞痛患者PCI术后的血小板功能,改善阿司匹林和氯吡格雷抵抗.Objective To investigate the effects of supplementing qi and activating blood circulation method（YQHX） on platelet inhibition rate and platelet membrane glycoprotein in elderly patients with unstable angina pectoris undergoing percutaneous coronary intervention（PCI）.Methods Totally 177 elderly patients with unstable angina（qi deficiency and blood stasis syndrome） pectoris were randomized into two groups：90 cases in the treatment group and 87 cases in the control group.Both groups received conventional western medicinal treatment,for 14 days but YQHX was added to the treatment group.Platelet inhibition rate and platelet membrane glycoprotein were measured before and 14 days after treatment.Results After 14 days of treatment,the platelet inhibition rates induced by arachidonic acid （AA） and adenosine diphosphate （ADP） were significantly increased in the treatment group in comparison to pre-treatment and to control group respectively（P〈0.01）.The prevalence of aspirin and clopidogrel resistance were lower in the treatment group than in the control group（8.9% vs.21.8%,11.1% vs.25.3%,both P〈0.05）.After 14 days of treatment,the expression rates of CD62p,CD63 and PAC-1 were significantly lower in the treatment group than in pre-treatment and control group respectively （P〈0.01）.Conclusions YQHX might effectively inhibit the platelet function and reduce the prevalence of aspirin and clopidogrel resistance in elderly patients with unstable angina pectoris undergoing the percutaneous coronary intervention.

关 键 词：心绞痛 不稳定型 血小板膜糖蛋白类 中草药 抗药性 

分 类 号：R541.4[医药卫生—心血管疾病]