目的探讨益气活血中药对血管损伤活性物质的调控机制。方法采用结扎SD大鼠左冠状动脉前降支方法制备动物模型,在心电图评价的基础上,将造模成功的动物随机分为模型组、益气活血组、培哚普利组和通心络组,以假手术组为对照组,共5组。选择治疗后7、28d为观察点,采用荧光实时定量PCR方法检测心肌组织中血栓调节蛋白(TM)、内皮细胞蛋白C受体(EPCR)的mRNA表达水平的变化,用ELISA方法检测血清内皮素-1(ET-1)、NO、前列腺素2(PGI:)、血栓素A,(TXA,)和可溶性内皮细胞蛋白C受体(sEPCR)、可溶性血栓调节蛋白(STM)水平。结果不同时间点,模型组大鼠血清ET-1、TXA2及sTM、sEPCR水平较假手术组明显上升(P〈0.01),血清NO、PGI,水平较假手术组明显下降(P〈0.01),益气活血组、培哚普利组和通心络组大鼠血清ET-1、TXA,及sTM、sEPCR水平较模型组明显下降(P〈0.01),血清NO、PGI,水平较模型组明显上升(P〈0.01);模型组大鼠心肌组织中TM、EPCR的mRNA水平较假手术组明显升高(P〈0.01),益气活血组、培哚普利和通心络组心肌组织中TM和EPCR的mRNA表达较模型组明显下降(P〈0.01)。结论心肌梗死后,大鼠血清中sTM、sEPCR明显升高,益气活血中药通过减少血清sTM、sEPCR水平,并降低心肌组织中的TM及EPCR的mRNA表达水平,修复受损内皮细胞功能,有效改善心梗大鼠的血管内皮功能,调节微循环的血流灌注,改善心肌缺血。
Objective To investigate the mechanism of Chinese medicinal with the actions of supplementing qi and activating blood in the regulation of vascular injury active substance. Methods The model of myocardial infarction (MI) was established by ligaturing the left anterior descending coronary artery in SD rats. On the base of ECG evaluation all successfully modeled rats were randomly divided into including model group, group treated with supplementing-qi and activating-blood Chinese medicinal (supplementing-qi and activating-blood group ), perindopril group, and group treated with Tongxinluo Capsules (Tongxinluo group). The sham-operation group was taken as the control group. There were totally 5 groups. The changes of expressions of thrombomodulin (TM) mRNA and endothelial protein C receptor (EPCR) mRNA in myocardium were detected by using real-time fluorescence quantitative polymerase chain reaction ( RT-PCR), and the levels of serum endothelin-1 ( ET-1 ), nitric oxide ( NO ), prostacycline ( PGI2 ), thromboxane ( TXA2 ), soluble TM ( sTM ) and soluble EPCR (sEPCR) were detected by using enzyme-linked immunosorbent assay (ELISA) at two time points (after 7 days and after 28 days). Results At different time points, the levels of serum ET-1, TXAz, sTM and sEPCR increased significantly (P 〈0. 01 ) and levels of NO and PGI2 decreased significantly (P 〈0. 01 ) in model group compared with sham-operation group. The levels of serum ET-1, TXA2, sTM and sEPCR decreased significantly ( P 〈 0. 01 ) and levels of NO and PGI2 increased significantly ( P 〈 0. 01 ) in supplementing-qi and activating-blood group, perindopril group and Tongxinluo group compared with model group. The expressions of TM mRNA and EPCR mRNA increased significantly in model group (P 〈0. 01 ) compared with sham-operation group, and decreased significantly in supplementing-qi and activating-blood group, perindopril group and Tongxinluo group (P 〈 0. 01 ) compared wit