丹参多酚酸盐对急性ST段抬高型心肌梗死患者介入治疗术后CD14^+单核细胞黏附能力和ToLL样受体的影响  

The effects of danshen duofen suanyan on CDl4^+ monocyte adhesive ability and Toll-like-receptor4 in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：王喜福[1] 张晓岩 叶明[1] 米玉红[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所急诊危重症中心,100029 [2]中央军委政治工作部话剧团管理处卫生科

出　　处：《心肺血管病杂志》2017年第2期82-85,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:观察丹参多酚酸盐对急性ST段抬高型心肌梗死经皮冠状动脉介入(PCI)术后患者CD14^+单核细胞CD11b/CD18、血浆黏附分子ICAM-1,及单核细胞与血管内皮细胞的黏附能力和Toll样受体的影响,以进一步探讨丹参多酚酸盐对急性心肌梗死患者单核细胞跨内皮细胞迁移能力的影响及其可能的机制。方法:选取我院2012年8月至2016年8月,因急性ST段抬高性心肌梗死入院患者300例,所有患者均行急诊PCI治疗。将300例患者随机分为常规治疗组(150例)和丹参多酚酸治疗组(150例)。常规治疗组予以阿司匹林、氯吡格雷和阿托伐他汀等药物口服,并急诊行PCI治疗。而丹参多酚酸治疗组除上述治疗外,予以注射用丹参多酚酸盐200mg静点,每日1次,持续5d。入院时及治疗5d末取静脉血6m L分离单核细胞,通过流式细胞仪、ELISA等方法检测单核细胞CD11b/CD18、血浆ICAM-1、单核细胞Toll受体4(TOLR4)表达的变化。并观察不同时间点、不同组别单核细胞与正常人脐静脉内皮细胞的黏附能力。另取30例健康自愿者为对照组。结果:治疗5d末,两组患者单核细胞CD11b/CD18、血浆ICAM-1及TLR4水平均较人院前明显降低(P<0.01),单核细胞与脐静脉内皮细胞的黏附能力显著下降(P<0.01);而与常规治疗组比较,治疗5d末丹参多酚治疗组单核细胞CD11b/CD18、血浆ICAM-1及TLR4水平显著降低(P<0.05);单核细胞与脐静脉内皮细胞的黏附能力降低(P<0.05)。结论:注射用丹参多酚盐能通过抑制CDl4^+单核细胞TLR4信号转导途径,抑制细胞间黏附分子的表达,降低急性心肌梗死PCI术后患者单核细胞与内皮细胞的黏附。这对降低急性心肌梗死后心肌损伤可能具有重要作用。Objective：To observe the effect of zhusheyong danshen duofensuanyan on CD14^＋ monocyte CDllb/CD18, plasma adhesion molecule ICAM -1, and the ability of mononuclear cells and vascular endotheli- al ceils adhesion and Toll-like receptors in patients with acute myocardial infarction after percutaneous coronary intervention （PCI） , and to explore the influence of mononuclear cells across the endothelial cell migration ability and its possible mechanism. Methods： We chose 300 patients with ST segment elavation acute myocardial in- farction from august 2012 to august 2016 in anzhen hospital, and all the patients received percutaneous coronary intervention treatment. All the patients were randomly divided into two groups： conventional treatment group （n = 150） and danshen duofen treatment group （n = 150）. The conventional treatment group was administered with aspirin, clopidogrel, atorvastatin calcium, and the Danshen Duofen treatment group was intravenously ad- ministered with Danshen Duofensuanyan 200mg once a day for 5 days besides aspirin, clopidogrel, atorvastatin calcium. Before admission and 5 days later, 6mL venous blood was obtained from all the patients, and mono- cyte CDllb/CD18, Toll-like receptors （TLR4）, plasma adhesion molecule ICAM-lwere investigated by flow cytometry instrument and ELISA method. And the ability of mononuclear cells and vascular endothelial cells ad- hesion was also detected at different time points. And blood smnples of 30 healthy volunteers were determined. Results： Five days later, the level of monocyte CDllb/CD18, plasma ICAM-land monocyte TLR4 decreased significantly compared with pre-admission（P 〈 0. O1 ） ; the ability of mononuclear cells and vascular endothelial cells adhesion was also inclined（P 〈 0.01 ）. Compared with conventional treatment group, the level of mono- cyte CD11 b/CD18, plasma ICAM-1 and monocyte TLR4 were increased significantly five days later（ P 〈 0. 05 ） ; The ability of mononuclear cells and vascular endothelial cel

关 键 词：丹参多酚酸盐 急性心肌梗死 经皮冠状动脉介入术 CDl4^＋单核细胞 黏附能力 TOLL 样受体 

分 类 号：R54[医药卫生—心血管疾病]