摘要
经皮冠脉成形术（ＰＴＣＡ）后再狭窄率高达３０％～４０％，严重影响了其治疗价值。为寻找有效的预防再狭窄的药物，本文研究了中药穿心莲提取物（ＡＰＮ）和鱼油（ω３脂肪酸）对去内皮和高胆固醇饮食诱发粥样硬化性兔髂动脉狭窄和血管成形后再狭窄的预防作用以及有关的作用机理。结果显示，ＡＰＮ能显著降低去内皮和高胆固醇饲养诱发的粥样硬化性髂动脉狭窄发生率，减轻狭窄程度，并能显著减轻血管成形后的再狭窄。作用机理的研究显示，饲入ＡＰＮ能显著抑制髂动脉去内皮和高胆固醇饲养兔血单核细胞分泌生长因子；显著改善或预防粥样硬化兔细胞膜的Ｃａ２＋－ＡＴＰ酶活性显著下降，有助于防止细胞内Ｃａ２＋负荷过重；体外和体内给ＡＰＮ均能显著降低静息血小板［Ｃａ２＋］ｉ及凝血酶刺激的血小板游离Ｃａ２＋浓度升高；穿心莲分离物还能呈剂量相关性地显著抑制成纤维细胞增殖。鱼油亦可减轻粥样硬化性动脉狭窄和血管成形后再狭窄，并抑制血单核细胞分泌生长因子和预防粥样硬化兔细胞膜Ｃａ２＋－ＡＴＰ酶活性下降，效果均较ＡＰＮ弱，只能作为预防ＰＴＣＡ后再狭窄的辅助药物。
Abstract Restenosis rate after coronary angioplasty has been up to 30%￣40%. In order to solve this problem,we studied the effects of a Chinese herb, extract of Andrographis Paniculata Nees (APN) and Fish Oil(FO,n3 polyunsaturated fatty acids over 70%)on atherosclerotic stenosis and restenosis after angioplasty in rabbits and the relevant mechanisms of APN and FO. The results showed that APN can significantly alleviate atheroclerotic iliac artery stenosis induced by both deendothelialization and high cholesterol feeding and restenosis following angioplasty in rabbits;FO shows the same action but milder than APN.The mechanisms of these drugs were further investigated and the results showed that both APN and FO (especially APN)can significantly inhibit blood monocytes to secrete.growth factors in vivo;Ca2+-ATPase activity of cell membrane of atherosclerotic rabbits wassignificantly decreased while APN or FO, especially the former may prevent this reduction,and thus intracellular Ca2+ overload was avoided as confirmed by the measurement of platelet [Ca++]i;APN can significantly decrease in vitro and in vivo the resting and thrombin-stimulated platelet [Ca2+]i and it can inhibit fibroblast proliferation in dose-dependent manner. In Conclusion,it is hopeful that APN can become one of effictive drugs in reducing incidence of restenosis after angioplasty and in preventing and treating coronary heart disease;FO has much milder efficacy than APN and can may serve as adjuvant in preventing restenosis.
出处
《中国介入心脏病学杂志》
1995年第1期32-36,共5页
Chinese Journal of Interventional Cardiology
