摘要
目的观察急性脑梗死患者血小板-白细胞聚集体(PLA)的变化以及阿司匹林和氯吡格雷对其的影响。方法对急性脑梗死和对照组患者血小板聚集率(PAR)、可溶性 P 选择素(sP-sel)、C-反应蛋白(CRP)和 PLA 进行检测。同时将急性脑梗死患者随机分为阿司匹林组和氯吡格雷组,观察两组患者治疗前后斯堪的纳维亚神经卒中量表(SNSS)评分、PAR、sP-sel、CRP 和 PLA 的变化。结果急性脑梗死患者血小板单核细胞聚集体(PMA)显著高于对照组(P<0.001);PMA 水平与 PAR、sP-sel、CRP、血糖、胆固醇和纤维蛋白原正相关(P<0.05);与 SNSS 评分负相关(P<0.05)。脑梗死患者治疗后 PMA、PAR 明显下降(P≤0.001),且治疗后氯吡格雷组 PMA 和 PAR(ADP)降低较阿司匹林组更明显(P<0.05),但 PAR(AA)两组间差异无统计学意义;sP-sel 在氯吡格雷组治疗后显著下降(P<0.001)。结论急性脑梗死患者反映血小板活化的敏感指标 PMA 明显增高,阿司匹林和氯吡格雷可以降低 PMA 水平,其中氯吡格雷作用较阿司匹林更为明显。
Objective To investigate the changes of platelet-leukocyte aggregation （PLA） in patients with cerebral infarction and the effects of antiplatelet agents on it. Methods The levels of plasma soluble P-selectin （sP-sel） , serum C-reactive protein （CRP） , platelet aggregation rate（PAR） and PLA were measured in 40 patients with acute cerebral infarction and 20 cases of controls. The 40 patients with cerebral infarction were randomly divided into aspirin-treated group （20 cases ）and clopidogrel-treated group （20 cases）scandinavian neurological sroke score （SNSS）, plasma sP-sel, serum CRP, PAR and PLA were observed before and after the treatment. Results Compared with controls, the percentage of monocyteplatelet aggregation（PMA） was significantly increased in the patients （ P 〈 0. 001 ）. The level of plasma sP-sel,serum CRP and PAR in the case group were significantly greater than those in the control group（ P 〈 0.05）. The level of PMA was positively related with the plasma sP-sel, serum CRP and PAR in cerebral infarction patients before treatment（ P 〈0. 05）, and it showed a significant inverse correlation between the percentage of PMA and the score of SNSS （ P 〈 0.05 ）. After treatment, the levels of PMA and PAR were decreased in both groups of cerebral infarction patients（ P≤0. 001 ）, and the level of PMA and PAR（ADP） in clopidogrel-treated group was lower than those in aspirin-treated group（ P 〈 0. 05 ）. However, the CRP in the patients was no significant difference before and after treatment. The level of sP-sel was no significant difference before and after treatment in aspirin-treated group, but it was significantly decreased after treatment in clopidogrel-treated group （ P 〈 0. 001 ）. Conclusions The levels of PMA in patients with cerebral infarction was significantly higher than in the controls. PMA may be a sensitive marker of platelet activation. Aspirin and Clopidogrel could decline the level of PMA in the patients with actue cerebr
出处
《中华内科杂志》
CAS
CSCD
北大核心
2007年第7期562-565,共4页
Chinese Journal of Internal Medicine
