Effect of Tongxinluo capsule on the expression of ox-LDL and LP-PLA2 in elderly patients withcerebral vascular stenosis and cerebral infarction
通心络胶囊治疗脑血管狭窄老年脑梗死患者的疗效及对血清ox-LDL与Lp-P LA2表达的影响

摘要

目的 探究通心络胶囊治疗脑血管狭窄老年脑梗死患者的疗效及对血清ox-LDL与Lp-PLA_2表达的影响。方法 选取2019年5月-2020年5月我院老年病科收治的106例脑,血管狭窄老年脑梗死患者为研究目标，按随机数字表法分为对照组和观察组，每组53例，对照组给以常规疗法，观察组在对照组的基础上给以通心络胶囊。治疗2个月后观察两组患者磷脂酸水平、血清脂联素、颈动脉内中膜厚度（Carotid intima thickness，CIMT）、血小板活性指标（包括血小板α颗粒膜蛋白-140 (Platelet particle membrane protein -140，GMP-140）、血栓烷素B2 （Thromboalkane B2，TXB2）、血小板活化因子（platelet activating factor，PAF）以及血小板凝集率、血清氧化低密度脂蛋白（oxidized low-density lipoprotein，ox-LDL）、脂蛋白相关磷脂酶 A2（lipoprotein associated phospholipase A2，Lp-PLA2）比较治疗效果和患者的生活质量，并观察不良反应。结果 治疗前两组患者血清磷脂酸、脂联素水平以及 CIMT无显著差异（P>0.05），而治疗后两组患者血清磷脂酸、脂联素水平以及 CIMT均显著改善，且观察组血清磷脂酸、CIMT明显低于对照组（P<0.05），脂联素水平明显高于对照组（P<0.05），差异有统计学意义；治疗前两组患者血小板活性各指标无显著差异（P>0.05），而治疗后两组患者血小板活性指标GMP-140、TXB2、PAF、血小板凝集率均显著改善，且观察组血小板活性明显低于对照组（P<0.05），差异有统计学意义；治疗前两组患者血清ox-LDL、Lp-PLA2水平无显著差异（P>0.05），而治疗后两组患者血清ox-LDL、Lp-PLA2均显著降低（P<0.05），且观察组明显低于对照组（P<0.05），差异有统计学意义；治疗前两组患者生存质量得分无显著差异（P>0.05），而治疗后两组患者生活质量均显著提高，且观察组明显高于对照组（P<0.05），差异有统计学意义；治疗后观察组组患者治疗有效率（92.45%）明显高于对照组（77.36%），不良反应发生率（7.55%）明显低于对照组（16.98%）。结论 通心络胶囊能保护神经功能，降低炎症反应，减轻脑梗死所致的组织损伤，从而降低脑血管狭窄老年脑梗死患者的血清ox-LDL、Lp-PLA2水平，提高患者生活质量，效果显著且安全性好。

Abstract

Objective To investigate the therapeutic effect of Tongxinluo capsule on elderly patients with cerebral vascular stenosis and cerebral infarction and its influence on the expression of ox-LDL and LP-PLA2 in serum.
Methods A total of 106 elderly patients with cerebral vascular stenosis and cerebral infarction admitted to the geriatric department of our hospital from May 2019 to May 2020 were selected as the research objective. According to the random number table method, they were divided into the control group and the observation group, with 53 patients in each group. The control group was given conventional therapy, and the observation group was given Tongxinluo capsule on the basis of the control group.After 2 months of treatment, the two groups of patients featured by their phospholipic acid level, serum adiponectin, carotid artery intima thickness (CIMT), Platelet activity index (including Platelet particle membrane protein-140, GMP-140), thromboalkane B2,TXB2), platelet activating factor (platelet activating factor, PAF) and platelet aggregation rate), serum oxidized low density lipoprotein (oxidized low density lipoprotein, ox - LDL), lipoprotein associated phospholipase A2 (lipoprotein associated phospholipase A2, Lp - PLA2) to compare treatment effects and the patient's quality of life, and to observe the adverse reaction.
Results Two groups of patients before treatment, phosphatidic acid, serum adiponectin levels and CIMT there was no significant difference (P>0.05), and two groups of patients after treatment, phosphatidic acid, serum adiponectin levels and CIMT were significantly improved, and the serum phosphatidic acid, CIMT observation group was obviously lower than the control group (P<0.05), adiponectin level is significantly higher than the control group (P<0.05), the difference was statistically significant.Before treatment, there was no significant difference in platelet activity indexes between the two groups (P>0.05), while after treatment, the platelet activity indexes of gmp-140, TXB2, PAF and platelet agglutination rate of the two groups were significantly improved, and the platelet activity of the observation group was significantly lower than that of the control group (P<0.05), with statistically significant differences.Before treatment, there was no significant difference in serum ox-LDL and Lp-PLA2 levels between the two groups (P>0.05), while after treatment, the serum ox-LDL and Lp-PLA2 levels of the two groups were significantly reduced (P<0.05), and the difference was statistically significant in the observation group compared with the control group (P<0.05).Before treatment, there was no significant difference in the quality of life scores between the two groups (P>0.05), but after treatment, the quality of life of the two groups was significantly improved, and the observation group was significantly higher than the control group (P<0.05), the difference was statistically significant.After treatment, the effective rate in the observation group(92.45%) was significantly higher than that in the control group(77.36%), and the incidence of adverse reactions (7.55%) was significantly lower than that in the control group (16.98%).
Conclusion   Tongxinluo capsule can protect nerve function, reduce inflammation, and reduce tissue damage caused by cerebral infarction, so as to reduce serum ox-LDL and LP-PLA2 levels in elderly patients with cerebral stenosis with cerebral infarction, and improve the quality of life of the patients, with significant effect and good safety.