Mechanisms Of Endothelin-1 And Endotoxin In Chronic Obstructive Pulmonary Disease Patients With Blood Stasis Syndrome

BACKGROUND: Endotoxin(ETx) was associate with acute lung injury, It has been hypothesized that ETx may have a role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and blood stasis syndrome(BSS) . OBJECTIVE: The aim of this study was to examine a possible correlation between endothelin (ET-1) and endotoxin level and the role in the pathogenesis of COPD and BSS. Furthermore we also determined the therapeutic effect of radix astragali seu hedysari and/or ligustrazine in treatment of COPD patients with BSS. METHODS: 150 COPD patients were randomized into 5 groups of 30 patients each: radix astragali seu hedysari group(RA), ligustrazine group(LIG), radix astragali seu hedysari plus ligiostrazine.group(RALIG), negative control group (NCG) and heparin control group (HCG) respectively. As additional control groups, we had set normal control group and CPHD group. The changes of plasma ETx and ET-1 were observed before and after 1 week, 2 weeks and 1 month of treatment, the whole blood viscosity in high shear (bH), whole blood viscosity in low shear(bL),thrombintime (TT), fibrinogen(FIB),D-dimer(DD), thromboxaneB2(TXB2), 6-keto-prostaglandin-F1 a (6-keto-PGF1 a )and the ratio of TXB2 and 6-keto-PGF1 a (T/P ratio) were also measured before and after 2 weeks of treatment. RESULTS: The results described as follow: (1)Compared with the normal control group, the ET-1 and ETx level got an obvious elevation in COPD and CPHD patients, even after 1 month of therapy;(2)Plasma ET-1 level was positively correlated with ETx in COPD and CPHD patients (3) bH, bL, FIB, DD, TXB2,T/P ratio elevated significantly in COPD and CPHD patients before therapy.(4)DD, T/P ratio were positively correlated with ETx.. So do bH with ET-1.(5)After radix astragali seu hedysari and/or ligustrazine therapy, the changes of ETx, ET-1, FIB and TXB2 in RALIG were more significant than NCG and HCG. CONCLUSION: According to our study we can conclude that: (1)Endotoxemia leads to the vascular endothelium injure and blood stasis. (2)ETx and ET-1 play important role in the pathogenesis of COPD and BSS. 〤ombination of radix astragali sen hedysari and ligustrazine showed a therapeutic effect better than that of two drugs used separately or heparin treatment. (7)The efficiency of lowering plasma ET-1 is correlated with the lowering of plasma ETx. ㏄rolonged endotoxemia is a possible trigger in the pathogenesis of COPD and BSS.