冠心通脉胶囊对冠心病心绞痛的临床研究
|
摘要
目的：观察冠心通脉胶囊对冠心病心绞痛患者血清中的一氧化氮(NO)、超敏C反应蛋白(Hs-CRP)及内皮素(ET)的影响。明确冠心通脉胶囊对冠心病心绞痛的疗效,探讨其可能作用机制,为其临床应用提供科学依据。
方法：将60患者按抽签法随机分成两组,治疗组在常规用药基础上加用冠心通脉胶囊,对照组则服用通心络胶囊,治疗观察一个疗程(4周)后,比较两组临床疗效,心电图改变,并分析治疗前后两组患者血中NO、ET、Hs-CRP的变化。
结果：治疗组心电图有效病例24例,无效4例,总有效率达85.7%,而对照组有效病例27例,无效3例,总有效率90.0%,在心电图疗效上两组比较差异无统计学意义(p>0.05)；治疗组临床疗效有效病例26例,无效2例,总有效率达92.9%,而对照组有效病例28例,无效病例2例,总有效率达933%,临床疗效上两组间差异无统计学意义(P>0.05)。治疗组NO由治疗前(87.24±9.31)umol/l上升到(110.17±9.35)umol/l,治疗前后比较差异有统计学意义(P<0.05)；ET由治疗前(118.12±31.67)ng/1下降到(99.46±24.98)ng/1,前后比较差异有统计学意义(p<0.05)；Hs-CRP由治疗前(8.55±2.34)mg/1下降到(4.97±2.13)mg/1,前后比较差异有统计学意义(p<0.05)；对照组NO由治疗前(88.93±8.45)umol/l上升到(113.52±7,88)umol/l,治疗前后比较差异有统计学意义(P<0.05)；ET由治疗前(121.5±33.94)ng/1下降到(102.21±28.76)ng/1,前后比较差异有统计学意义(p<0.05); Hs-CRP由治疗前(8.61±2.18)mg/1下降到(5.34±2.37)mg/l,前后比较差异有统计学意义(p<0.05)；两组间治疗前后NO、ET、Hs-CRP比较差异无统计学意义(p>0.05)。
结论：冠心通脉胶囊对冠心病心绞痛有一定疗效,其可能作用机制是通过促进NO的释放、降低ET及Hs-CRP的水平,对血管内皮功能的保护来实现,具体机制有待于进一步阐明。
Objective:To observe the influence of Guanxintongai capsule on nitric oxide (NO)High sensitivity C-reactive protein(Hs-CRP) and Endothelin(ET) of patients who suffered angina pectoris of the disease of coronary heart disease and make clear the effects by treating with the Guanxintongmai capsule in order to explore the probably mechanisms, and give us some credible scientific basis for the clinical application.
Methods:Sixty patients with angina pectoris were randomly divided into two groups:Treatment group(n=30) treated with guanxintongmai capsule and the control group (n=30) with tongxinluo capsule for four weeks. then we analyze the levels of ET/NO/hs-CRP between the patients.
Results:Effective treatment of patients ECG observed in 24 cases, 4 cases, the total effective rate of 85.7%, while the control group,27 cases of effective cases and ineffective in 3 cases, the total efficiency of 90.0% Compared with this it has no Significant difference between two groups (p>0.05); Effective treatment of patients clinical binefis observed in 26cases,2 cases, the total effective rate of 92.9%, while the control group,28 cases of effective cases and ineffective in 2 cases, the total efficiency of 93.3% Compared with this it has no Significant difference between the two groups (p>0.05); NO by the treatment group before treatment (87.24±9.31)umol/l up to (110.17±9.35)umol/l, it has Significant difference between the two groups, ET from the before treatment (118.12±31.67)ng/l down to (99.46±24.98)ng/l, it has Significant difference between the two groups; Hs-CRP by the treatment (8.55±2.34)mg/l decreased to (4.97±2.13)mg/l, it has Significant difference between the two groups; but NO from the control group before treatment (88.93±8.45)umol/l up to (113.52±7.88)umol/l, it has Significant difference between the two groups; ET decreased from (121.5±33.94)ng/l down to (102.21±28.76)ng/l, it has Significant difference between the two groups; Hs-CRP by the treatment (8.61±2.18)mg/l decreased to (5.34±2.37)mg/l, it has Significant difference between the two groups;At last we found that the Indicators of two groups has its significant difference.
Conclusion:Guanxintongmai capsule has significantly influence on NO, ET, Hs-CRP for protectioning of endothelial function.
方法：将60患者按抽签法随机分成两组,治疗组在常规用药基础上加用冠心通脉胶囊,对照组则服用通心络胶囊,治疗观察一个疗程(4周)后,比较两组临床疗效,心电图改变,并分析治疗前后两组患者血中NO、ET、Hs-CRP的变化。
结果：治疗组心电图有效病例24例,无效4例,总有效率达85.7%,而对照组有效病例27例,无效3例,总有效率90.0%,在心电图疗效上两组比较差异无统计学意义(p>0.05)；治疗组临床疗效有效病例26例,无效2例,总有效率达92.9%,而对照组有效病例28例,无效病例2例,总有效率达933%,临床疗效上两组间差异无统计学意义(P>0.05)。治疗组NO由治疗前(87.24±9.31)umol/l上升到(110.17±9.35)umol/l,治疗前后比较差异有统计学意义(P<0.05)；ET由治疗前(118.12±31.67)ng/1下降到(99.46±24.98)ng/1,前后比较差异有统计学意义(p<0.05)；Hs-CRP由治疗前(8.55±2.34)mg/1下降到(4.97±2.13)mg/1,前后比较差异有统计学意义(p<0.05)；对照组NO由治疗前(88.93±8.45)umol/l上升到(113.52±7,88)umol/l,治疗前后比较差异有统计学意义(P<0.05)；ET由治疗前(121.5±33.94)ng/1下降到(102.21±28.76)ng/1,前后比较差异有统计学意义(p<0.05); Hs-CRP由治疗前(8.61±2.18)mg/1下降到(5.34±2.37)mg/l,前后比较差异有统计学意义(p<0.05)；两组间治疗前后NO、ET、Hs-CRP比较差异无统计学意义(p>0.05)。
结论：冠心通脉胶囊对冠心病心绞痛有一定疗效,其可能作用机制是通过促进NO的释放、降低ET及Hs-CRP的水平,对血管内皮功能的保护来实现,具体机制有待于进一步阐明。
Objective:To observe the influence of Guanxintongai capsule on nitric oxide (NO)High sensitivity C-reactive protein(Hs-CRP) and Endothelin(ET) of patients who suffered angina pectoris of the disease of coronary heart disease and make clear the effects by treating with the Guanxintongmai capsule in order to explore the probably mechanisms, and give us some credible scientific basis for the clinical application.
Methods:Sixty patients with angina pectoris were randomly divided into two groups:Treatment group(n=30) treated with guanxintongmai capsule and the control group (n=30) with tongxinluo capsule for four weeks. then we analyze the levels of ET/NO/hs-CRP between the patients.
Results:Effective treatment of patients ECG observed in 24 cases, 4 cases, the total effective rate of 85.7%, while the control group,27 cases of effective cases and ineffective in 3 cases, the total efficiency of 90.0% Compared with this it has no Significant difference between two groups (p>0.05); Effective treatment of patients clinical binefis observed in 26cases,2 cases, the total effective rate of 92.9%, while the control group,28 cases of effective cases and ineffective in 2 cases, the total efficiency of 93.3% Compared with this it has no Significant difference between the two groups (p>0.05); NO by the treatment group before treatment (87.24±9.31)umol/l up to (110.17±9.35)umol/l, it has Significant difference between the two groups, ET from the before treatment (118.12±31.67)ng/l down to (99.46±24.98)ng/l, it has Significant difference between the two groups; Hs-CRP by the treatment (8.55±2.34)mg/l decreased to (4.97±2.13)mg/l, it has Significant difference between the two groups; but NO from the control group before treatment (88.93±8.45)umol/l up to (113.52±7.88)umol/l, it has Significant difference between the two groups; ET decreased from (121.5±33.94)ng/l down to (102.21±28.76)ng/l, it has Significant difference between the two groups; Hs-CRP by the treatment (8.61±2.18)mg/l decreased to (5.34±2.37)mg/l, it has Significant difference between the two groups;At last we found that the Indicators of two groups has its significant difference.
Conclusion:Guanxintongmai capsule has significantly influence on NO, ET, Hs-CRP for protectioning of endothelial function.
引文
[1]国际心脏病医学会和协会及世界卫生组织临床命名标准化联合专题组的报告,缺血性心脏病命名及诊断标准[J].中华内科杂志,1981,20(4)：254-255.
[2]孙晓红,李淑琴,祖秀光,等.一氧化氮和内皮素在银杏叶提取物治疗老年冠心病中的作用[J].辽宁中医杂志,2009,36(7)：1144-1145.
[3]Sun BL, Zhang J, Wang XC, et al. Effects of extract of Ginkgo bi loba on spasms of the balilar atery and cerebralm icrocircullatory perusion in rats with subarachnoid hemoeehage [J]. ClinHemorheol Microcirc,2003,29 (3-4):231-238.
[4]Zhang C, Zu J, Shi H, et al.The effect of Ginkgo biloba extract (Egb761)on hepatic sinusoidal endothelial cells and hepatic microcirculation in CC14 rats[J]. Am J Chin Med,2004,32 (1): 21-31.
[5]Kubota Y, Tanaka N, Kagota S, et al. Effects of Ginkgo biloba ext ract on blood perssure and vascular endothelial response byacety lcholine in spontaneously hypertensive rats [J]. J Pharm Phanr macol,2006,58(2):23-24.
[6]王静.中药对血管内皮功能的保护作用[J].中国动脉硬化杂志,2005,13(1)：116-118.
[7]蔡锡麟,张文镇.用86Rb研究脉塞通对小鼠营养性心肌血流量的影响[J].中成药研究,1987,(9)：45.
[8]王永发,杨福春,张艳.三七总皂苷治疗心脑血管病的研究进展[J].云南中医中药杂志,1997,18(4)：36.
[9]Chan P, Thomas GN, tromlinson B. Protective effects of Trilinolein extracted from Panax notoginseng against cardiovascular disease [J].Planta Med,2002,68:1024.
[10]孙小梅,纪三娇.三七总皂苷对冠心病病人血浆内颗粒膜蛋白和血小 板聚集的影响[J].数理医药学杂志,1998,23(3)：173-175.
[11]唐旭东,姜建肯,姜大春,等.三七总皂苷对心肌缺血-再灌注中性粒细胞核因子-κB活化及粘附的影响[J].中国药理学通报,2002,18(5)：556-558.
[12]吕萍,陈海峰.三七叶苷降脂作用的实验研究[J].中国生化药物杂志,2004,25(4)：235-236.
[13]袁志兵,李晓辉,李淑慧,等.三七总皂苷对动脉粥样硬化斑块稳定性的影响[J].中国天然药物,2006,4(1)：62-64.
[14]Gal is ZS, Sukhova KG, Lark MW, et al. Increased expression of matr ix metalloprotease and matrix degrading activity invoulnerable regions of human atheroscleroticplaques [J].Clin Invest,1994, 94 (6):1493-1503.
[15]李艳玲,孟晓萍,曲玲.基质金属蛋白酶在急性心肌梗死患者血清中的表达[J].中华急诊医学杂志,2003,12(4)：231-233.
[16]许军,王阶,温林军.三七总皂苷干预血栓形成研究概况[J].云南中医中药杂志,2003,24(5)：46-47.
[17]苏雅,赵益桂,张宗鹏,等.三七三醇皂苷对动物血小板功能及血栓形成的影响[J].中草药,1996,27(1)：666-669.
[18]葛茂庭.三七总皂苷治疗高血压病的临床疗效观察[J].河北医学,2009,15(11)：1288-1289.
[19]王佑华,周端,曹敏等.三七花总苷对自发性高血压大鼠血压及心率的影响[J].中西医结合心脑血管病杂志,2007,5(10)：965-967.
[20]朱晓奕,周亚平,辛淮生,等.三七超细粉对兔心肌缺血再灌注损伤的保护作用[J].时珍国医国药,2009,26(5)：1114-1119.
[21]Xu QF, Fang XL,Chen DF. Pharmacoki-netics and Bioavailability of ginsenoside Rbl and Rgl from panax Notoginseng inrats[J]. JEhnopharmacology,2003,84:187-192.
[22]李自成,曹茂银,宋翠娥,等.当归注射液对冠心病患者血浆前列环素／ 血栓素A2和血小板聚集的影响[J].中国中西医结合杂志,1997,17(7):430.
[23]韩红,范幼筠,张克俭,等.当归注射液对2型糖尿病患者血液流变学及凝血功能的影响[J].武汉大学学报,2003,24(1)：65-67.
[24]李敏,孙虹.不同产地当归对血小板聚集及凝血时间活性的比较[J].中国中医基础医学杂志,2003,9(2)：47-50.
[25]熊瑛,张端莲.当归注射液预处理对大鼠心肌缺血再灌注损伤后心肌ICAM-1表达的变化[J].数理医药学杂志,2008,21(4)：412-414.
[26]侯明晓,敖定椿.人参总皂甙抗心肌缺血再灌注损伤的作用机理[J].中国胸心血管外科临床杂志,2000,7(4)：256-259.
[27]黄警,张纡,杨丹莉,等.人参总皂苷对PDGF-BB所致血管平滑肌胞增殖周期的影响[J].中国药理学通报,2010,26(6)：787-791.
[28]李凤娥,孔繁利,李威.人参二醇组皂苷抗动脉粥样硬化作用实验研究[J].北华大学学报(自然科学版),2009,10(6)：498-500.
[29]何胜虎,张晶.过氧化氢体外诱导人血管内皮细胞损伤与人参皂苷Rb1的保护效应[J].基础医学,2008,12(2)：254-257.
[30]王茜,林焕冰,程玉芳,等.淫羊藿苷对高脂血症大鼠粘附因子基因表达的影响[J].中国动脉硬化杂志,2008,16(1)：4-6.
[31]何航,沈晓君,冯黎.淫羊藿苷对动脉粥样硬化兔动脉内皮细胞损伤的保护作用[J].中医研究,2009,22(12)：15-17.
[32]王秋娟,潘志伟,岳攀,等.淫羊藿总黄酮对动物性心肌缺血及血流变学的影响[J].中草药,2007,38(7)：1039-1042.
[33]马一君,魏晏,朱静媛,等.淫羊藿苷对半胱氨酸刺激的血管平滑肌细胞增殖的影响[J].时珍国医国药,2010,21(7)：1714-1715.
[34]赵保胜,宓惠卿.冰片对大鼠脑微血管内皮细胞ICAM-1表达量的影响[J].中药新药与临床药理,2001,18(4)：332.
[35]覃仁安,孙学惠,邱德文,等.米槁乐滴丸抗心肌缺血作用的实验研究[J].中国药房,1997,8(6)：250.
[36]杨蕾,李伟荣,宓穗卿,等.冰片对三氯化铁诱导的大鼠动脉血栓形成的抑制作用及机制[J].中国实验方剂学杂志,2010,16(6),164-167.
[37]李荣,吴伟,李文晞,等.延胡索碱预处理对缺血再灌注心肌钙泵及钠钾泵活性的影响[J].辽宁中医杂志,2010,37(8)：1613-1615.
[38]Xin J F,Wang M N,M a X Y, et al. Effects of d1tetrahydropal mation on rabbit platelet aggregation and experimental cereb ral thrombosis in rats [J]. Chin Pharmacol Bull(中国药理学通报),1997,13(3)：258-260.
[39]Furchgott R F, et al:Nature (Lond) 1980,288:373-376.
[40]Moncada S,et al:Phramacol RCV1991,43:109-142.
[41]胡爱玲,蔡久英.内皮功能紊乱与冠心病致病机制研究进展[J].医学综述,2006,12(4)：207-209.
[42]lihling C,Szombathy T, Bohrmann B. Coexpression of endothelin convertingenzme and endothelin-1 in different stages of human atherosclerosis[J]. Circulation,2001,104 (8):864-869.
[43]Ihling C, Bohrmann B, Schaefer HE,et al. Endothelin and endothe lin converting enzye in human atherosclerosis novel targets for pharmaco therapy in atherosclerosis [J].Curr Vase Pharacol, 2004,2 (3):249-258.
[44]Pietila KO, Harmoinen AP,Jokinitty J, et al. Serun C-reactive protein concentraion in acute myo-cardial infarction andits relationship to mortality during 24 months of follow-up in patients under thrombolytic treatment[J]. Eur Heart J,1999, 17:1345-1349.
[45]Ridlker PM, Hennekens CH,Burning JE,et al. C-reactive protein and other markers of inflammation in the prediction of cardi ovascular disease in wowen[J].N Eng J Med,2000,342:836-843.
[46]Eern E, Yilimaz N, Pence S, et al. Diagnostic value of C-reactive protein in patients with angiographieally documented coronary heart disease [J]. Aeta Medic (HradecKraove),2002,45 (4):155.
[47]Cermak J, Key NS, Bach RR, et al. C-reactive protein induce shuman peripheral blood momocytes to synthesize tissufactor [J]. Blood ,1993,82:513.
[48]Subodh V, Chao-Hung W, Shu-Hong L, et al. C-reactive perotein Att enuates nitric oxide production and inhibit asngiogenesis [J]. Circulation,2002,106:913.
[49]贾勤.急性ST段抬高型心肌梗死患者CRP水平与内皮功能相关性研究[J].白求恩军医学院学报,2010,8(1)：29-31.
[50]Alvarez GB, Ruizc, Chacon P,et al.High-sensitivity c-reactive protein in high-grade carotid stenosis:risk marker for unsta ble carotid palque[J].J Vasc Surg,2003,38(5):1011-1024.
[51]容建清.高敏C反应蛋白与冠心病相关性研究[J].中国老年保健医学,2009,7(3)：45-46.
[52]Kang ES, Kim HJ, Kim YM, et al. Serum high sensitivity c-reactive protein is associated with carotid intima-media thick-ness in type-diabetes [J]. Diabetes Res Clin Pract,2004,66(Suppl 1),S 115-120.
[53]赵志敏.冠心病患者超敏C反应蛋白测定的临床应用[J].实用医技杂志,2008,15(24)：3217-3218.
[54]Lusis AJ. Atherosclerosis [J]. Nature,2000,407:223.
[55]毕进,王禹.通心络胶囊对不稳定型冠心病患者血管内皮功能的影响[J].辽宁医学杂志,2009,23(1)：11-13.
[56]黄永康.通心络胶囊与阿托伐他汀联合调脂临床观察[J].中国医药指南,2010,8(30)：289--290.
[57]张路,吴宗贵,廖德宁,等.通心络对实验性家兔主动脉粥样斑块内血管内皮生长因子表达的影响[J].中国动脉硬化杂志,2004,12(2)：177 -182.
[58]Subodh V. Michae R B, Todd J A. Endothelial function testing as a biomarker of vascular disease[J]. Circulation,2003,108 (17): 2054-2059.
[59]Yen E T, Willerson J T. coming of age of C-reactive protern:Use ing inflammation markers in cardiology [J].Circulation,2003, 107(3):370-371.
[60]刘艳,张蕾,张运,等.动脉粥样硬化斑块炎性因子表达及通心络胶囊的干预作用[J].上海中医药杂志,2007,41(12)：54-56.
[61]段炼,杨跃进,张海涛,等.猪急性心肌梗死再灌注后氧化应激损伤及通心络的保护作用[J].中国病理生理杂志,2010,26(3)：430-434.
[62]赵晖,田建会,郝晓燕,等.通心络对高脂血症兔血清脂质过氧化的影响[J].中华中医药学刊,2010,28(8)：1755-1756.
[63]王琦,刘镇,雷健.冠心通脉胶囊抗心肌缺血的作用机制探讨[J].中国中医药科技,2007,14(6)：439.
[1]Ross R,Glomset JA. Aherosclerosis and the arterial smooth mus-cle cell:Proliferation of smooth muscle is a key even in the genesis of the lesions of atherosclerosis[J]. Science,1973,180 (93):1332-1339.
[2]郭磊,吴延庆.内皮细胞功能不全与冠心病[J].江西医学院学报,2003,43(2)：129-131.
[3]李磊,戴敏.动脉粥样硬化血管内皮分泌功能失调与平滑肌细胞增殖[J].中国药理学通报,2010,26(2)：155-158.
[4]Li D M, Zhang C L, Song F, et al.VEGF regulates FGF-2 and TGF-β1 expression in injury endothelial cells and ediates smooth musule cells proliferation and migration[J].Microvascular Res ,2009,77(1):134-142.
[5]Raymond M A, Desormraus A, Laplane P, et al.Apoptosis of endothe-lial cells triggers a caspase-dependent anti-apoptotic parac rine loop active on vascular smooth uscle cells [J]. FASEB J, 2004,18 (6):705-723.,
[6]赵慧娟,龙明智.内皮细胞功能障碍与动脉粥样硬化的研究进展[J].中西医结合心脑血管病杂志,2005,3(6)：533-535.
[7]马焕云,魏芳.血管内皮功能影响因素与动脉粥样硬化[J].新医学,2005,36(6)：362-364.
[8]孙斌,李来生,郑延松.内皮功能紊乱与心血管疾病研究进展[J].心血管病学进展,2003,24(4)：300-303.
[9]Suzuki M, Takamisawa I, Suzuki K, et al. Close association of endo thelial dysfunction with insulin resistance and carotid wall thickening in hyper tens ion [J]. Am J Hypertens,2004,17 (3):228-232.
[10]祝之明主编.代谢综合症病因探索与临床实践.北京：人民军医出版社 ,2005:225-230.
[11]Kawano H, Motoyam T, Hirashima 0, et al. Hyoerglycemia rapidly suppresses flow-mediated endotheliumdependent vasodilation of brachial artery[J].J AM Coll Cardiol,1999,34 (1):146-154.
[12]Ceriello A. New insights on oxidative stress and diabetic complications may lead to a causal antioxidant therapy[J]. Diabetes Care,2003,26:1589-1596.
[13]Schimidt AM, Yan S D, Wautier JL, et al. Activation of receptor for advanced glycation end products:a mechanism for chronic vascular dysfunction in diabetic vasculopathy adn at herosc lerosis [J]. Cire Res,1999,84:489-497.
[14]Diehm C, Kareem S, Lawall H. Epidemiology of peripheral arterial disease [J]. Vasa,2004,3 (4):183-189.
[15]梁艺媖,钟国强.高脂血症与血管内皮细胞功能异常研究进展[J].内科,2007,2(2)：246-249.
[16]李榕,王文清,张海锋,等.高血脂通过氧化/硝基化双重作用介导大鼠血管内皮功能失调[J].中国病理生理杂志,2010,26(8)：1494-1497.
[17]CaiH, Harrison DG. Endothelial dysfunction in cardiovascular diseases the role of oxidant stress [J].Circ Res,2000,87 (10) :840-844.
[18]王邦宁,胡泽平,陈大年,等.高血压患者血肝细胞生长因子与血管内皮功能的关系及干预研究[J].中华高血压杂志,2007,15(3)：219-222.
[19]Andreozzi F, Laratta E, Sciacqua A, et al. Angiotensin Ⅱ impairs osphorylation of the insulin signaling pathway promoting pro duction of nitric oxide by inducing phosphorylation of insu lin receptor substrate-1 on Ser312 and Ser616 in human umbi lical vein endothelial cells [J].Circ Res,2004,94 (9):1211-12 18.
[20]Schlaich MP, Parnell MM, Ahlers BA,et al. Impaired L-arginine transport and endothelial function in hypertensive and gene tically predisposed normotensive subjects [J]. Circulation,20 04,110 (24):3680-3686.
[21]郑雯,李树青.原发性高血压血管内皮细胞损害机制的研究和治疗进展[J].心血管病学进展,2009,30(1)：65-69.
[22]Kugiyama K, Yasue H,Ohgushi M, et al. Deficiency in nitric oxide bioactivit in epicardial coronary arteries of cigarette smo kers[J].J Am Coll Cardiol,1996,28:1161-1167.
[23]Scott DA, Stapleton JA, Wilson RF, et al. Draatic decline in circu lation intercellualr adhesion olecule-1 concentration on quit ting tobacco smoking [J]. Blood cells Mol Dis,2000,26(3):255-258.
[24]Muriel VT. Tuar C. Yolandc A, et al. Effects of tobacco smoke and benzo(a)pyrene on human endothelial cell an monocyte stress responses[J]. Am J Physiol Heart Circ Physiiol,2001,280(3): H1293-H1300.
[25]Lepsanovic L, Brkljac 0. Effect of smoking on hpoprotein metabo lism [J]. Med Pregl,2001,52 (9-10):453.
[26]蔡久英,高薇,徐兆龙,等.不同饮酒量对心血管内皮功能及炎性因子的影响[J].中国急救医学,2010,30(9)：829-831.
[27]俞梦越,吴维力,高润霖.内皮功能不全与冠心病[J].心血管病学进展,2002,23(4)：193-199.
[28]Rossi R, Nuzzo A,Olaru AL,et al. Endothelial function affects early carotid atherosclerosis progression in hypertensive post menopausal women [J]. Journal of Hypertens,2011,29:1136-1144.
[29]Vanhoutte PM. Endothelial dysfunction and atherosclerosis [J] .Eur Heart J,1997,18 (supplE):E19-E29.
[30]尚晋,陈群.血管内皮功能障碍与动脉粥样硬化[J].福建医药杂志,2006,28(6)：105-107.
[31]Kiseljakovic E, Valjevac A, Hasic S, et al. Association of homocy steine with traditional and non-traditional risk factors in patients with atherosclerotic vascular disease[J].Med Glas Ljek komore Zenicko-doboj kantona,2011,8 (1):126-133.
[2]孙晓红,李淑琴,祖秀光,等.一氧化氮和内皮素在银杏叶提取物治疗老年冠心病中的作用[J].辽宁中医杂志,2009,36(7)：1144-1145.
[3]Sun BL, Zhang J, Wang XC, et al. Effects of extract of Ginkgo bi loba on spasms of the balilar atery and cerebralm icrocircullatory perusion in rats with subarachnoid hemoeehage [J]. ClinHemorheol Microcirc,2003,29 (3-4):231-238.
[4]Zhang C, Zu J, Shi H, et al.The effect of Ginkgo biloba extract (Egb761)on hepatic sinusoidal endothelial cells and hepatic microcirculation in CC14 rats[J]. Am J Chin Med,2004,32 (1): 21-31.
[5]Kubota Y, Tanaka N, Kagota S, et al. Effects of Ginkgo biloba ext ract on blood perssure and vascular endothelial response byacety lcholine in spontaneously hypertensive rats [J]. J Pharm Phanr macol,2006,58(2):23-24.
[6]王静.中药对血管内皮功能的保护作用[J].中国动脉硬化杂志,2005,13(1)：116-118.
[7]蔡锡麟,张文镇.用86Rb研究脉塞通对小鼠营养性心肌血流量的影响[J].中成药研究,1987,(9)：45.
[8]王永发,杨福春,张艳.三七总皂苷治疗心脑血管病的研究进展[J].云南中医中药杂志,1997,18(4)：36.
[9]Chan P, Thomas GN, tromlinson B. Protective effects of Trilinolein extracted from Panax notoginseng against cardiovascular disease [J].Planta Med,2002,68:1024.
[10]孙小梅,纪三娇.三七总皂苷对冠心病病人血浆内颗粒膜蛋白和血小 板聚集的影响[J].数理医药学杂志,1998,23(3)：173-175.
[11]唐旭东,姜建肯,姜大春,等.三七总皂苷对心肌缺血-再灌注中性粒细胞核因子-κB活化及粘附的影响[J].中国药理学通报,2002,18(5)：556-558.
[12]吕萍,陈海峰.三七叶苷降脂作用的实验研究[J].中国生化药物杂志,2004,25(4)：235-236.
[13]袁志兵,李晓辉,李淑慧,等.三七总皂苷对动脉粥样硬化斑块稳定性的影响[J].中国天然药物,2006,4(1)：62-64.
[14]Gal is ZS, Sukhova KG, Lark MW, et al. Increased expression of matr ix metalloprotease and matrix degrading activity invoulnerable regions of human atheroscleroticplaques [J].Clin Invest,1994, 94 (6):1493-1503.
[15]李艳玲,孟晓萍,曲玲.基质金属蛋白酶在急性心肌梗死患者血清中的表达[J].中华急诊医学杂志,2003,12(4)：231-233.
[16]许军,王阶,温林军.三七总皂苷干预血栓形成研究概况[J].云南中医中药杂志,2003,24(5)：46-47.
[17]苏雅,赵益桂,张宗鹏,等.三七三醇皂苷对动物血小板功能及血栓形成的影响[J].中草药,1996,27(1)：666-669.
[18]葛茂庭.三七总皂苷治疗高血压病的临床疗效观察[J].河北医学,2009,15(11)：1288-1289.
[19]王佑华,周端,曹敏等.三七花总苷对自发性高血压大鼠血压及心率的影响[J].中西医结合心脑血管病杂志,2007,5(10)：965-967.
[20]朱晓奕,周亚平,辛淮生,等.三七超细粉对兔心肌缺血再灌注损伤的保护作用[J].时珍国医国药,2009,26(5)：1114-1119.
[21]Xu QF, Fang XL,Chen DF. Pharmacoki-netics and Bioavailability of ginsenoside Rbl and Rgl from panax Notoginseng inrats[J]. JEhnopharmacology,2003,84:187-192.
[22]李自成,曹茂银,宋翠娥,等.当归注射液对冠心病患者血浆前列环素／ 血栓素A2和血小板聚集的影响[J].中国中西医结合杂志,1997,17(7):430.
[23]韩红,范幼筠,张克俭,等.当归注射液对2型糖尿病患者血液流变学及凝血功能的影响[J].武汉大学学报,2003,24(1)：65-67.
[24]李敏,孙虹.不同产地当归对血小板聚集及凝血时间活性的比较[J].中国中医基础医学杂志,2003,9(2)：47-50.
[25]熊瑛,张端莲.当归注射液预处理对大鼠心肌缺血再灌注损伤后心肌ICAM-1表达的变化[J].数理医药学杂志,2008,21(4)：412-414.
[26]侯明晓,敖定椿.人参总皂甙抗心肌缺血再灌注损伤的作用机理[J].中国胸心血管外科临床杂志,2000,7(4)：256-259.
[27]黄警,张纡,杨丹莉,等.人参总皂苷对PDGF-BB所致血管平滑肌胞增殖周期的影响[J].中国药理学通报,2010,26(6)：787-791.
[28]李凤娥,孔繁利,李威.人参二醇组皂苷抗动脉粥样硬化作用实验研究[J].北华大学学报(自然科学版),2009,10(6)：498-500.
[29]何胜虎,张晶.过氧化氢体外诱导人血管内皮细胞损伤与人参皂苷Rb1的保护效应[J].基础医学,2008,12(2)：254-257.
[30]王茜,林焕冰,程玉芳,等.淫羊藿苷对高脂血症大鼠粘附因子基因表达的影响[J].中国动脉硬化杂志,2008,16(1)：4-6.
[31]何航,沈晓君,冯黎.淫羊藿苷对动脉粥样硬化兔动脉内皮细胞损伤的保护作用[J].中医研究,2009,22(12)：15-17.
[32]王秋娟,潘志伟,岳攀,等.淫羊藿总黄酮对动物性心肌缺血及血流变学的影响[J].中草药,2007,38(7)：1039-1042.
[33]马一君,魏晏,朱静媛,等.淫羊藿苷对半胱氨酸刺激的血管平滑肌细胞增殖的影响[J].时珍国医国药,2010,21(7)：1714-1715.
[34]赵保胜,宓惠卿.冰片对大鼠脑微血管内皮细胞ICAM-1表达量的影响[J].中药新药与临床药理,2001,18(4)：332.
[35]覃仁安,孙学惠,邱德文,等.米槁乐滴丸抗心肌缺血作用的实验研究[J].中国药房,1997,8(6)：250.
[36]杨蕾,李伟荣,宓穗卿,等.冰片对三氯化铁诱导的大鼠动脉血栓形成的抑制作用及机制[J].中国实验方剂学杂志,2010,16(6),164-167.
[37]李荣,吴伟,李文晞,等.延胡索碱预处理对缺血再灌注心肌钙泵及钠钾泵活性的影响[J].辽宁中医杂志,2010,37(8)：1613-1615.
[38]Xin J F,Wang M N,M a X Y, et al. Effects of d1tetrahydropal mation on rabbit platelet aggregation and experimental cereb ral thrombosis in rats [J]. Chin Pharmacol Bull(中国药理学通报),1997,13(3)：258-260.
[39]Furchgott R F, et al:Nature (Lond) 1980,288:373-376.
[40]Moncada S,et al:Phramacol RCV1991,43:109-142.
[41]胡爱玲,蔡久英.内皮功能紊乱与冠心病致病机制研究进展[J].医学综述,2006,12(4)：207-209.
[42]lihling C,Szombathy T, Bohrmann B. Coexpression of endothelin convertingenzme and endothelin-1 in different stages of human atherosclerosis[J]. Circulation,2001,104 (8):864-869.
[43]Ihling C, Bohrmann B, Schaefer HE,et al. Endothelin and endothe lin converting enzye in human atherosclerosis novel targets for pharmaco therapy in atherosclerosis [J].Curr Vase Pharacol, 2004,2 (3):249-258.
[44]Pietila KO, Harmoinen AP,Jokinitty J, et al. Serun C-reactive protein concentraion in acute myo-cardial infarction andits relationship to mortality during 24 months of follow-up in patients under thrombolytic treatment[J]. Eur Heart J,1999, 17:1345-1349.
[45]Ridlker PM, Hennekens CH,Burning JE,et al. C-reactive protein and other markers of inflammation in the prediction of cardi ovascular disease in wowen[J].N Eng J Med,2000,342:836-843.
[46]Eern E, Yilimaz N, Pence S, et al. Diagnostic value of C-reactive protein in patients with angiographieally documented coronary heart disease [J]. Aeta Medic (HradecKraove),2002,45 (4):155.
[47]Cermak J, Key NS, Bach RR, et al. C-reactive protein induce shuman peripheral blood momocytes to synthesize tissufactor [J]. Blood ,1993,82:513.
[48]Subodh V, Chao-Hung W, Shu-Hong L, et al. C-reactive perotein Att enuates nitric oxide production and inhibit asngiogenesis [J]. Circulation,2002,106:913.
[49]贾勤.急性ST段抬高型心肌梗死患者CRP水平与内皮功能相关性研究[J].白求恩军医学院学报,2010,8(1)：29-31.
[50]Alvarez GB, Ruizc, Chacon P,et al.High-sensitivity c-reactive protein in high-grade carotid stenosis:risk marker for unsta ble carotid palque[J].J Vasc Surg,2003,38(5):1011-1024.
[51]容建清.高敏C反应蛋白与冠心病相关性研究[J].中国老年保健医学,2009,7(3)：45-46.
[52]Kang ES, Kim HJ, Kim YM, et al. Serum high sensitivity c-reactive protein is associated with carotid intima-media thick-ness in type-diabetes [J]. Diabetes Res Clin Pract,2004,66(Suppl 1),S 115-120.
[53]赵志敏.冠心病患者超敏C反应蛋白测定的临床应用[J].实用医技杂志,2008,15(24)：3217-3218.
[54]Lusis AJ. Atherosclerosis [J]. Nature,2000,407:223.
[55]毕进,王禹.通心络胶囊对不稳定型冠心病患者血管内皮功能的影响[J].辽宁医学杂志,2009,23(1)：11-13.
[56]黄永康.通心络胶囊与阿托伐他汀联合调脂临床观察[J].中国医药指南,2010,8(30)：289--290.
[57]张路,吴宗贵,廖德宁,等.通心络对实验性家兔主动脉粥样斑块内血管内皮生长因子表达的影响[J].中国动脉硬化杂志,2004,12(2)：177 -182.
[58]Subodh V. Michae R B, Todd J A. Endothelial function testing as a biomarker of vascular disease[J]. Circulation,2003,108 (17): 2054-2059.
[59]Yen E T, Willerson J T. coming of age of C-reactive protern:Use ing inflammation markers in cardiology [J].Circulation,2003, 107(3):370-371.
[60]刘艳,张蕾,张运,等.动脉粥样硬化斑块炎性因子表达及通心络胶囊的干预作用[J].上海中医药杂志,2007,41(12)：54-56.
[61]段炼,杨跃进,张海涛,等.猪急性心肌梗死再灌注后氧化应激损伤及通心络的保护作用[J].中国病理生理杂志,2010,26(3)：430-434.
[62]赵晖,田建会,郝晓燕,等.通心络对高脂血症兔血清脂质过氧化的影响[J].中华中医药学刊,2010,28(8)：1755-1756.
[63]王琦,刘镇,雷健.冠心通脉胶囊抗心肌缺血的作用机制探讨[J].中国中医药科技,2007,14(6)：439.
[1]Ross R,Glomset JA. Aherosclerosis and the arterial smooth mus-cle cell:Proliferation of smooth muscle is a key even in the genesis of the lesions of atherosclerosis[J]. Science,1973,180 (93):1332-1339.
[2]郭磊,吴延庆.内皮细胞功能不全与冠心病[J].江西医学院学报,2003,43(2)：129-131.
[3]李磊,戴敏.动脉粥样硬化血管内皮分泌功能失调与平滑肌细胞增殖[J].中国药理学通报,2010,26(2)：155-158.
[4]Li D M, Zhang C L, Song F, et al.VEGF regulates FGF-2 and TGF-β1 expression in injury endothelial cells and ediates smooth musule cells proliferation and migration[J].Microvascular Res ,2009,77(1):134-142.
[5]Raymond M A, Desormraus A, Laplane P, et al.Apoptosis of endothe-lial cells triggers a caspase-dependent anti-apoptotic parac rine loop active on vascular smooth uscle cells [J]. FASEB J, 2004,18 (6):705-723.,
[6]赵慧娟,龙明智.内皮细胞功能障碍与动脉粥样硬化的研究进展[J].中西医结合心脑血管病杂志,2005,3(6)：533-535.
[7]马焕云,魏芳.血管内皮功能影响因素与动脉粥样硬化[J].新医学,2005,36(6)：362-364.
[8]孙斌,李来生,郑延松.内皮功能紊乱与心血管疾病研究进展[J].心血管病学进展,2003,24(4)：300-303.
[9]Suzuki M, Takamisawa I, Suzuki K, et al. Close association of endo thelial dysfunction with insulin resistance and carotid wall thickening in hyper tens ion [J]. Am J Hypertens,2004,17 (3):228-232.
[10]祝之明主编.代谢综合症病因探索与临床实践.北京：人民军医出版社 ,2005:225-230.
[11]Kawano H, Motoyam T, Hirashima 0, et al. Hyoerglycemia rapidly suppresses flow-mediated endotheliumdependent vasodilation of brachial artery[J].J AM Coll Cardiol,1999,34 (1):146-154.
[12]Ceriello A. New insights on oxidative stress and diabetic complications may lead to a causal antioxidant therapy[J]. Diabetes Care,2003,26:1589-1596.
[13]Schimidt AM, Yan S D, Wautier JL, et al. Activation of receptor for advanced glycation end products:a mechanism for chronic vascular dysfunction in diabetic vasculopathy adn at herosc lerosis [J]. Cire Res,1999,84:489-497.
[14]Diehm C, Kareem S, Lawall H. Epidemiology of peripheral arterial disease [J]. Vasa,2004,3 (4):183-189.
[15]梁艺媖,钟国强.高脂血症与血管内皮细胞功能异常研究进展[J].内科,2007,2(2)：246-249.
[16]李榕,王文清,张海锋,等.高血脂通过氧化/硝基化双重作用介导大鼠血管内皮功能失调[J].中国病理生理杂志,2010,26(8)：1494-1497.
[17]CaiH, Harrison DG. Endothelial dysfunction in cardiovascular diseases the role of oxidant stress [J].Circ Res,2000,87 (10) :840-844.
[18]王邦宁,胡泽平,陈大年,等.高血压患者血肝细胞生长因子与血管内皮功能的关系及干预研究[J].中华高血压杂志,2007,15(3)：219-222.
[19]Andreozzi F, Laratta E, Sciacqua A, et al. Angiotensin Ⅱ impairs osphorylation of the insulin signaling pathway promoting pro duction of nitric oxide by inducing phosphorylation of insu lin receptor substrate-1 on Ser312 and Ser616 in human umbi lical vein endothelial cells [J].Circ Res,2004,94 (9):1211-12 18.
[20]Schlaich MP, Parnell MM, Ahlers BA,et al. Impaired L-arginine transport and endothelial function in hypertensive and gene tically predisposed normotensive subjects [J]. Circulation,20 04,110 (24):3680-3686.
[21]郑雯,李树青.原发性高血压血管内皮细胞损害机制的研究和治疗进展[J].心血管病学进展,2009,30(1)：65-69.
[22]Kugiyama K, Yasue H,Ohgushi M, et al. Deficiency in nitric oxide bioactivit in epicardial coronary arteries of cigarette smo kers[J].J Am Coll Cardiol,1996,28:1161-1167.
[23]Scott DA, Stapleton JA, Wilson RF, et al. Draatic decline in circu lation intercellualr adhesion olecule-1 concentration on quit ting tobacco smoking [J]. Blood cells Mol Dis,2000,26(3):255-258.
[24]Muriel VT. Tuar C. Yolandc A, et al. Effects of tobacco smoke and benzo(a)pyrene on human endothelial cell an monocyte stress responses[J]. Am J Physiol Heart Circ Physiiol,2001,280(3): H1293-H1300.
[25]Lepsanovic L, Brkljac 0. Effect of smoking on hpoprotein metabo lism [J]. Med Pregl,2001,52 (9-10):453.
[26]蔡久英,高薇,徐兆龙,等.不同饮酒量对心血管内皮功能及炎性因子的影响[J].中国急救医学,2010,30(9)：829-831.
[27]俞梦越,吴维力,高润霖.内皮功能不全与冠心病[J].心血管病学进展,2002,23(4)：193-199.
[28]Rossi R, Nuzzo A,Olaru AL,et al. Endothelial function affects early carotid atherosclerosis progression in hypertensive post menopausal women [J]. Journal of Hypertens,2011,29:1136-1144.
[29]Vanhoutte PM. Endothelial dysfunction and atherosclerosis [J] .Eur Heart J,1997,18 (supplE):E19-E29.
[30]尚晋,陈群.血管内皮功能障碍与动脉粥样硬化[J].福建医药杂志,2006,28(6)：105-107.
[31]Kiseljakovic E, Valjevac A, Hasic S, et al. Association of homocy steine with traditional and non-traditional risk factors in patients with atherosclerotic vascular disease[J].Med Glas Ljek komore Zenicko-doboj kantona,2011,8 (1):126-133.