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氯吡格雷对急性冠脉综合征血小板活化的干预研究 被引量:8

Clopidogrel on platelet activation of acute coronary syndrome
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摘要 目的通过对急性冠脉综合征(ACS)氯吡格雷治疗前后的血小板最大聚集率(PAGM)、P-选择素(P-sel)、血小板膜纤维蛋白原(Fg)及血浆血栓素B2(TXB2)的检测,了解ACS患者血小板活化状态以及抗血小板治疗在急性冠脉综合征的意义。方法ACS患者40例随机分为A、B组,分别于入院后口服进口氯吡格雷(波立维)和国产氯吡格雷(泰嘉)300mg,2h后再次检测以上指标。次日分别予波立维或泰嘉维持量75mg/d,一周后重复检测以上指标。结果①用药前,A、B组与C组(对照组)间4项指标均有显著差异,A、B组间无显著差异。②ACS组服药2h后各项指标均显著下降,一周后以上各指标仍维持在较低水平。结论血小板活化在ACS中起相当重要的作用。氯吡格雷的抗血小板疗效确切。国产氯吡格雷与进口氯吡格雷具有相似的抗血小板疗效。PAGM、全血法流式细胞术检测血小板膜P-sel方便、迅速、准确,可作为血小板活化的指标用于临床预测急性血栓形成。 Objective The aim of the trials to detect platelet aggregation , P - selection, fibrinogen binding to platelet and thromboxaneB2 in plasma in the patients with acute coronary syndrome was to understand the situation that platelet activates and the significance of anti - platelet therapy in the patients with ACS . The detection was performed before and after taking clopidogrel. Methods The patients were randomized to two groups, including A group , B group. Venous blood samples were obtained before taking orally clopidogrel,2 hours after taking clopidogrel 300mg and after 75 mg qd for seven days in two clopidogrel groups in order to test the detections. Results ①Before taking clopidogrel all the detections in patients with ACS were significantly higher than those in control. There were no significant differences between Plavix group and Talcom group. ②Two hours after taking 300 mg clopidogrel all the detections of the patients were significantly decreased. After seven days ,so did the detections. Conclusion 1. The platelet activation plays an important role in ACS. The platelet aggregation , P - selection ,fibrinogen binding platelet ,TXB2 of the ACS are higher than those of the controls. The anti - platelet effects of clopidogrel is significant. The anti - platelet effects of domestic clopidogrel Talcom are similar to those of the imported clopidogrel Plavix. 3. PAGM and the detection of P - selection by FCM in blood can be done easy, quickly, accurately. As a mark of platelet activation, they can provide the prediction of the information of acute thrombosis.
出处 《临床和实验医学杂志》 2008年第12期15-17,共3页 Journal of Clinical and Experimental Medicine
关键词 急性冠脉综合征 氯吡格雷 血小板聚集率 P-选择素 血小板膜纤维蛋白原 血栓素B2 Acute coronary syndrome Platelet aggregation P -selection Fibrinogen binding to platelet Fhromboxane B2
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