通心络胶囊对脑梗死患者血小板聚集功能的影响

目的观察通心络胶囊对脑梗死患者血小板聚集功能的影响,探讨其可能的作用机制。方法74例恢复期脑梗死患者,根据入选时是否正在服用阿司匹林分为通心络胶囊单用组30例,在阿司匹林基础上加通心络胶囊的合用组44例。采用二磷酸腺苷、肾上腺素、胶原和花生四烯酸为诱导剂,观察所有患者在加用通心络胶囊后血小板聚集率的变化。结果单用组对二磷酸腺苷、肾上腺素诱导的血小板聚集率(%)在治疗后(80·9±16·5、91·8±4·0)较治疗前(88·5±4·9、92·9±3·1)下降,差异有统计学意义(P<0·05)。合用组对二磷酸腺苷、花生四烯酸诱导的血小板聚集率在治疗后〔62·0±16·3、17·7(10·2~23·7)〕较治疗前〔66·9±13·5、22·7(13·5~32·6)〕下降,差异有统计学意义(分别P<0·05、P<0·01)。合用组阿司匹林抵抗的例数在治疗后(10例,23%)较治疗前(20例,45%)减少,差异有统计学意义(P<0·05)。通心络胶囊与阿司匹林合用后未见明显不良反应增加。结论通心络胶囊具有抑制血小板聚集作用,机制可能与二磷酸腺苷和花生四烯酸途径的抑制有关,同时与阿司匹林合用相对安全。

英文摘要:

ObjectiveTo observe the effect of Tongxinluo Capsule (TXL) on platelet aggregation in patients with cerebral infarction, and to explore its underlying mechanisms. MethodsSeventy-four patients with cerebral infarction at the rehabilitation stage were assigned to two groups according to taking or not taking aspirin at hospitalization, the 30 patients in group A were administered with TXL alone and the 44 in group B with TXL combined with aspirin. Platelet aggregation tests induced by adenosine diphosphate, epinephrine, collagen and arachidonic acid were conducted in all patients to evaluate the effect of TXL on platelet aggregation. ResultsPlatelet aggregation rate induced by adenosine diphosphate and epinephrine decreased after treatment in Group A from 88.5±4.9 and 92.9±3.1 to 80.9±16.5 and 91.8±4.0 respectively (P<0.05); that induced by adenosine diphosphate and arachidonic acid decreased after treatment in Group B from 66.9±13.5 and 22.7 (13.5～32.6) to 62.0±16.3 and 17.7 (10.2～23.7) respectively (P<0.05 and P<0.01). Cases of aspirin resistance reduced in Group B from 20 (45%) to 10 (23%), also showing statistical difference (P<0.05). No obvious increase of side effect was found after combined use of TXL with aspirin. ConclusionTXL has anti-platelet aggregation effect, its mechanism may be related with the inhibition of adenosine diphosphate and arachidonic acid path. It is relatively safe when used in combination with aspirin.

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