摘要
目的探讨抗血小板药物阿司匹林与氯吡格雷联合应用对不同年龄组老年急性冠状动脉综合征（ACS）患者血小板活化功能的影响。方法72例老年ACS患者按照年龄不同分为80岁及以下组及80岁以上组，均给予氯吡格雷75mg／d与阿司匹林100mg／d联合应用2周，运用流式细胞仪（FCM）测定各组经二磷酸腺苷（ADP）及花生四烯酸体外共同活化的血小板膜表面糖蛋白的阳性表达率，比较血小板膜糖蛋白Ⅱb／Ⅲa（GPⅡb／Ⅲa）及P-选择素的阳性表达率的变化。结果80岁及以下组血小板膜表面糖蛋白GPⅡb／Ⅲa及P-选择素的基线阳性表达率分别为（73．5±11．0、71．2±8．7）％，联合应用抗血小板药物14d后，血小板GPⅡb／Ⅲa及P-选择素的阳性表达率分别为（51.3±9．1、57．3±12．4）％；80岁以上组血小板膜表面糖蛋白GPⅡb／Ⅲa及P选择素的基线阳性表达率分别为（78．3±12．7、75．8±8．6）％，联合应用抗血小板药物14d后，血小板GPⅡ／Ⅲa及P-选择素的阳性表达率分别为（41．2±8．5、47．3±10．3）％，80岁以上组血小板GPlIb／Ⅲa及P选择素的阳性表达率降低（P〈O．05）。结论氯吡格雷和阿司匹林联合应用抑制血小板活化效果在80岁以上老年ACS患者较80岁及以下老年ACS患者明显增加。
Objective To investigate the effect of combined anti-platelets drugs on platelet activation in the elderly patients with acute coronary syndrome （ACS）. Methods Totally 72 elderly patients with ACS were divided randomly into two groups according to age ≤ 80 years and 〉 80 years. Aspirin 100 mg/d plus clopidogrel 75 mg/d were used in all the patients for 2 weeks. The positive glycoprotein Ⅱb/Ⅲa and P-selectin expressions on the surface of platelets were assessed with flow cytometry （FCM） after the platelets were activated by adenosine diphosphate （ADP） and arachidonic acid. Results The expressions of GP Ⅱb/Ⅲa and P-selectin were （73.5 ± 11.0, 71.2 ± 8. 7）% at baseline and （51.3±9.1, 57.3±12.4）% after anti-platelets medicine more than 14 days in group of age≤80 years, than 14 days. The expression of GP Ⅱb/Ⅲa and P-selectin were （78.3± 12.7, 75.8±8.6）% on the surface of platelet at baseline in group of age〉 80 years, after anti platelets medicine treatment were （41.2±8.5, 47.3± 10.3）%. The positive expressions of GP Ⅱb/Ⅲa and P-selectin in group of age〉 80 years were decreased compared with those in group of age〉80 years after combination of medicines treatment （P〈0.05）. Conclusions Combined aspirin and Clopidogrel treatment have a more strong effect in inhibiting the activation of platelets in the elderly patients more than 80 year with ACS.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第10期850-853,共4页
Chinese Journal of Geriatrics
