目的 探讨影响痰瘀互结证急性冠脉综合征(Acme coronary syndrome，ACS)患者血小板功能及活性的相关因素及化瘀祛痰方对其的作用。方法 前瞻性开放标签招募2022年6月—2023年6月就诊于辽宁中医药大学附属医院心内科，符合痰瘀互结证ACS诊断标准同时服用双联抗血小板聚集药物患者50例为研究对象，给予化瘀祛痰方治疗4周。检测化瘀祛痰方治疗前后血小板压积(Plateletcrit，PCT)、花生四烯酸(Arachidonic acid，AA)最大聚集率、二磷酸腺苷(Adenosinediphosphate，ADP)最大聚集率、血小板活化标记物全血P选择素CD62p、血小板膜糖蛋白Ⅱ b/Ⅲa复合物PAC-1水平，探讨化瘀祛痰方对其的作用。同时采用Pearson、Spearman相关系数分析探讨血小板功能及活性参数与ACS重要危险因素:吸烟史、体质量指数(Body Mass Index，BMI)、血脂水平、2型糖尿病病史、高血压病病史的相关性。结果 1。化瘀祛痰方治疗后，痰瘀互结证ACS患者血清总胆固醇(Total Cholesterol，TC)、低密度脂蛋白胆固醇(Low densi-ty lipoprotein，LDL-C)水平明显下降，载脂蛋白A1(Apoprotein A1，APO-A1)水平明显上升，差异有统计学意义(P＜0。01);血清甘油三酯(Triglycerides，TG)、载脂蛋白 B(Apoprotein B，APO-B)、脂蛋白 A[Lipoprotein(a)，LPa]水平呈下降趋势，高密度脂蛋白胆固醇(High density lipoprotein，HDL-C)水平呈上升趋势，但差异无统计学意义(P＞0。05)。2。化瘀祛痰方治疗后，痰瘀互结证ACS患者血小板压积减低，AA最大聚集率下降，CD62p、PAC-1含量降低，差异有统计学意义(P＜0。01);ADP最大聚集率下降，差异有统计学意义(P＜0。05)。3。吸烟史、BMI、血脂水平与AA、ADP最大聚集率、CD62p、PAC1、血小板压积均无明显关系;2型糖尿病病史与血小板压积之间存在显著相关关系(P＜0。05)，且为正相关;高血压病病史与AA最大聚集率、CD62p之间存在显著相关关系(P＜0。05)，且均为正相关。结论 化瘀祛痰方能够一定程度上降低痰瘀互结证ACS患者血小板聚集功能及活性，发挥其防治痰瘀互结证ACS的作用。吸烟史、BMI以及血脂水平与痰瘀互结证ACS患者血小板聚集功能及活性均无明显相关性。2型糖尿病病史与痰瘀互结证ACS患者血小板压积之间存在正相关。高血压病病史与痰瘀互结证ACS患者AA最大聚集率、CD62p之间存在正相关。
Exploring Influencing Factors of Platelet Function and Activity in Patients with Acute Coronary Syndrome with Phlegm and Blood Stasis Syndrome and The Intervention Effect of Huayu Qutan Formula(化瘀祛痰方)
Objective To explore the influencing factors of platelet function and activity in patients with acute coronary syn-drome(ACS)with phlegm and blood stasis syndrome and the effect of Huayu Qutan Formula(化瘀祛痰方)on it.Methods Pro-spective open label recruitment:From June 2022 to June 2023,50 patients who met the diagnostic criteria for ACS patients with phlegm and blood stasis syndrome and took dual antiplatelet aggregation drugs were recruited from the Department of Cardiology of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.They were treated with Huayu Qutan Formula for 4 weeks.The plateletcrit(PCT),arachidonic acid(AA)maximum aggregation rate,adenosine diphosphate(ADP)maximum aggre-gation rate,platelet activation marker whole blood P-selectin CD62p and blood platelet membrane glycoprotein Ⅱb/Ⅲa complex PAC-1 were detected before and after treatment with Huayu Qutan Formula and explore the effect of Huayu Qutan Formula on it.At the same time,Pearson and Spearman correlation coefficient analysis was used to explore the correlation between platelet function and activity parameters and important risk factors of ACS included smoking history,body mass index(BMI),blood lipid level,type 2 diabetes history and hypertension history.Results 1.After the treatment with Huayu Qutan Formula,the serum lev-els of total cholesterol(TC)and low density lipoprotein(LDL-C)of ACS patients with phlegm and blood stasis syndrome signifi-cantly decreased,while the apoprotein A1(APO-A1)level significantly increased,with a statistically significant difference(P＜0.01).The levels of triglycerides(TG),apoprotein B(APO-B)and lipoprotein(a)(LPa)showed a downward trend,while the levels of high density lipoprotein cholesterol(HDL-C)showed an upward trend,but the difference was not statistically significant(P＞0.05).2.After the treatment of Huayu Qutan Formula,the PCT of ACS patients with phlegm and blood stasis syndrome decreased,the maximum aggregation rate of AA decreased,and the contents of CD62p and PAC-1 decreased,with statistical sig-nificance(P＜0.01).The maximum aggregation rate of ADP decreased,and the difference was statistically significant(P＜0.05).3.There was no significant correlation of smoking history,BMI and blood lipid levels and the maximum aggregation rates of AA and ADP,the contents of CD62p,PAC1 and PCT.There was a significant positive correlation between the history of type 2 diabetes and PCT(P＜0.05).There was a significant correlation between the history of hypertension and the maximum aggre-gation rate of AA and CD62p,all of which were positively correlated(P＜0.05).Conclusion Huayu Qutan Formula can to some extent reduce the platelet aggregation function and activity of ACS patients with phlegm and blood stasis syndrome,and plays its role in preventing and treating ACS with phlegm and blood stasis syndrome.There is no significant correlation between smoking history,BMI,blood lipid levels and platelet aggregation function and activity in ACS patients with phlegm and blood stasis syn-drome.There is a positive correlation between the history of type 2 diabetes and PCT in ACS patients with phlegm and blood sta-sis syndrome.There is a positive correlation between the history of hypertension and the maximum aggregation rate of AA and CD62p in ACS patients with phlegm and blood stasis syndrome.
ACS of phlegm and blood stasis syndromeplatelet function and activityHuayu Qutan Formula(化瘀祛痰方)
万方数据
维普
