Research On The Change Of Plasma Coronary Atherosclerosis Correlation Factors And The Effect Of Sodium Ozagrel On Them

Part 1 Study on Insulin Resistance, Serum Visfatin, Adiponectin, ThromboxaneB2 and ProstaglandinI2 of Patients with Coronary Heart DiseaseObjective:Atherosclerosis(AS) is one kind of pathological procedures of chronic inflammatory disease, including inflammatory cell infiltrate, vascular smooth muscle cell multiplication, extracellular matrix increase and thrombogenesis. Generally, there are complicated relationships among severity of coronary atherosclerosis, insulin resistance(IR), serum visfatin, adiponectin(APN), thromboxaneA2(TXA2), prostaglandinI2 (PGI2) and the invasion of coronary heart disease(CHD). But in previous studies on the relationship between these factors and coronary heart disease, few synthetic studies, especially those combined with coronary angiography, were done. Fewer studies were carried out to have synthetic research into the relationship combined the degree of coronary artery pathological changes. There were not enough contrast studies on the different degrees of coronary heart disease. So, the characteristics that the levels of insulin resistance, serum visfatin, adiponectin, thromboxaneB2 and prostaglandinI2 changed with the degree of coronary artery pathologies could not be accurately explained. The objective of this research is to investigate the relatingship between these factors of insulin resistance, serum visfatin, adiponectin, thromboxaneB2 and prostaglandinI2 and the severity of coronary artery patholgies, and to supply a new method to prevent and cure coronary artery disease through observing the changes of these factors in the different degree of coronary artery pathologies.Methods:90 patients as objects of observation were analysed by coronary angiography of Judkins method and the results were evaluated by Gensini CA score standard.All cases were divided into 4 groups:without disease group(control group, Score=0), mild disease group(A group, Score<20), moderate disease group(B group, Score 20～40), and severe disease group(C group, Score>40) by Gensini CA score standard Blood was to draw before coronary angiography. Plasma insulin radio-immunifaction, blood glucose were detected by o-toluidine method, and IR was estimated by insulin action index(IAI).6-K-PGF1αand TXB2 were detected by radio-immunifaction. Serum visfatin and APN were detected by enzyme linked immunosorbent assay. The change and associativity of IAI,6-K-PGF1α, TXB2, visfatin and APN in different severity groups were observed.Results:(1)The levels of IAI between the CHD group and the control group had statistical significance(P<0.01). The levels of IAI between different severity groups and the control group had statistical significance (P<0.05 or P<0.01). The levels of IAI between different severity groups had statistical significance by group comparison(all P<0.01).(2)The analysis of variance showed the level of serum visfatin was higher significantly(F=117.691,P＜0.001)and the level of serum APN was lower significantly(F=74.503, P<0.001)along with the Gensini score increased when the degree of coronary artery pathological changes aggravated. The levels of visfatin and APN between different severity groups and the control group had statistical significance(all P<0.001). The levels of visfatin and APN between different severity groups had statistical significance by group comparison(all P＜0.001).(3) The analysis of variance indicated the level of 6-K-PGF1αwas lower significantly(F=115.439, P＜0.001)and the level of serum TXB2 was higher significantly(F=116.258, P<0.001) along with the Gensini score increased when the degree of coronary artery pathological changes aggravated. The levels of 6-K-PGF1α, TXB2 between different severity groups and the control group had statistical significance(all P＜.001). The levels of 6-K-PGFlα, TXB2 between different severity groups had statistical significance by group comparison(all P<0.001).(4) In CHD group, insulin resistance, serum visfatin, adiponectin, thromboxaneB2 and prostaglandinl2 had closely related with the score of Gensini CA score standard.And IAI was negatively related with TXB2 and visfatin, but positively related with 6-K-PGF1 and APN.6-K-PGFlαwas negatively related with TXB2 and visfatin, but positively related with APN. TXB2 was positively related with visfatin but negatively related with APN. Visfatin was negatively related with APN.Conclusions:(1)IAI was negatively related with the degree of pathological changes. there is a close relation between IR and the degree of pathological changes in CA.(2)Visfatin and TXA2 were negatively related with IAI,and they were positively related with the degree of pathological changes in CHD group.PGI2 and APN were positively related with IAI,and they were negatively related with the degree of pathological changes in CHD group.It suggests that the four factors were related with IR and the form and development of CHD. Part 2 Effect of Ozagrel on Serum Visfatin, Adiponectin, ThromboxaneB2 and ProstaglandinⅠ2 of Patients with Coronary Heart DiseaseObjective:AS is the common pathological foundation of many cardiovascular and cerebrovascular diseases, as well as the most frequent pathological changes of CHD. Ozagrel, a kind of thromboxane synthetase inhibitor (TXSI), has been the important drug to treat ischemic cerebro- vascular disease in clinic, and its safety and efficacy had been verified by a great quantity of investigation. But there were few reports about Ozagrel on CHD. The effect of Ozagrel on serum visfatin, APN, TXB2 and 6-K-PGFlaof patients with CHD was observed in this study to evaluate its value on CHD.Methods:72 patients who had one or more coronary stenosis by coronary angiography were randomly divided into 2 groups:the control group and the experiment group. In the control group,5000 U Low Molecular Heparin was hypodermically injected twice a day for 7 days;75mg Aspirin was taken orally every day; 20mg Isosorbide mononitrate added into 250 ml 5% Glucose was intravenously dripped once a day for 14 days; and 10mg Simvastatin was taken orally every night.β-blockers and/or calcium blockers were added as they needed. In the experiment group, on the basis of the treatment of the control group,80 mg sodium Ozagrel (Danao,produced by Dandong Pharmaceutical Factory)added into 250ml Sodium Chloride was intravenously dripped once a day for 14 days by 20～30 drops per minute. The treatment course of the two groups lasted 2 weeks. Blood from ulnar vein was drawn at the day of coronary angiography and the next morning after 14-day treatment on an empty stomach basis.6-K-PGFlαand TXB2 were detected by radio-immunifaction, and Serum visfatin and APN were detected by enzyme linked immunosorbent assayResults:(1)The level of 6-K-PGFla of the control group had no difference from that of the experiment group before therapy. But after treatment, the level of 6-K-PGFlawas comparatively increased in two the groups(P P<0.001), and 6-K-PGFlaof the experiment group was higher than that of the control group after treatment(P P＜0.05).(2)The level of TXB2 of the control group had no difference from that of the experiment group before therapy. But after treatment, the level of TXB2 was comparatively decreased in the two groups(P<0.001), and TXB2 of the experiment group was lower than that of the control group after treatment(P<0.01).(3)The level of APN of the control group had no difference from that of the experiment group before therapy. But after treatment, the level of APN was comparatively increased in the two groups(P<0.001), and APN of the experiment group was higher than that of the control group after treatment(P<0.01).(4)The level of Visfatin of the control group had no difference from that of the experiment group before therapy. But after treatment, the level of Visfatin was comparatively decreased in the two groups(P<0.001), and Visfatin of the experiment group was lower than that of the control group after treatment(P<0.01).Conclusions:The level of Visfatin was decreased and the level of APN was increased in patients with AS by sodium ozagrel.The level of TXA2 was increased and the level of PGI2 was decreased in patients with AS by sodium ozagrel. So, sodium ozagrel could improve the balance of PGI2 and TXA2. It suggested that sodium ozagrel could contribute to improve inflammatory reaction and delay vascular pathological changes.