新型体外反搏对冠心病患者血清PGI2，t-PA，TXB2，AngⅡ的影响

摘要

Objective To investigate the effect of enhanced external counterpulsation ( EECP) on serum PGI2、t-PA、TXB 2 and AngⅡin patients with coronary heart disease ( CHD) and its mechanism.Methods The serum PGI 2、t-PA、TXB 2 and AngⅡlevels of 100 cases of CHD were tested.Patients were divided into EECP group (52 cases) and medication group (48 cases).The serum concentrations of PGI 2、t-PA、TXB2 and AngⅡof each group before and after treatment were compared for the correlation analysis.Results After 2 weeks medication treatment or EECP treatment , compared withthe levels before treatment , the serum levels in CHD patients EECP group were as follows.PGI2 and t-PA increased significantly ( P<0.05 ) , TXB2 and AngⅡ decreased significantly ( P<0.05 ).Conclusions Coronary heart disease patients with vascular endothelial dysfunction , fibrinolytic function decreased.Enhanced external counter-pulsation can reduce the TXB 2 and AngⅡproduction , and promote the release of PGI 2 and t-PA, reduce lipid peroxi-dation, stabilizing the vulnerable plaque , and has a protective effect on endothelial cells , which may be one of the mech-anisms of enhanced external counterpulsation therapy of coronary heart disease in clinic .%目的：观察新型体外反搏（EECP）对冠心病患者血清前列环素（Prostacyclin PGI2），组织型纤溶酶原激活物（t-PA），血栓素B2（TXB2），血管紧张素Ⅱ（angio tensin Ⅱ，AngⅡ）的影响，探讨EECP治疗冠心病的机制。方法收集100例冠心病患者（体外反搏组52例，单纯药物组48例）治疗前后外周静脉血清，两组均予常规药物治疗，体外反搏组每天给予60 min体外反搏，每周五次，二周为一疗程。采用酶联免疫吸附法（ ELISA）检测测定各血清中PGI 2，t-PA ，TXB 2，AngⅡ的水平，并进行各组分析比较PGI 2，t-PA ，TXB2，AngⅡ的水平。结果经过单纯2周药物治疗和联合新型体外反搏治疗后，较治疗前相比，冠心病患者外周血清中PGI2， t -PA ， TXB2，AngⅡ水平：在体外反搏组TXB2，AngⅡ含量明显降低（P＜0.05），PGI2，t-PA含量明显升高（P＜0.05）；而在药物治疗组， PGI2，t-PA ，TXB2，AngⅡ含量虽有变化，但均无明显变化（ P＞0.05）。结论冠心病患者呈血管内皮功能失调，纤溶系统功能降低。新型体外反搏可降低TXB2，AngⅡ的产生，并促进PGI2，t-PA的释放，减轻脂质过氧化反应，稳定易损斑块，对血管内皮有保护作用，这是新型体外反搏为临床上治疗冠心病的提供了新途径。