噻氯匹定对急性冠脉综合征患者血小板活化状态的干预研究

The intervention of Ticlide on platelet activation in acute coronary syndrome

目的了解噻氯匹定对急性冠脉综合征患者血小板活化的干预状况。方法对85例临床疑似急性冠脉综合征患者服用噻氯匹定250mg,2次/d及阿斯匹林100mg,1次/d熏疗程3d,并在服药前后测定血小板表面颗粒膜糖蛋白(CD62P)和溶酶体膜糖蛋白(CD63)的表达程度。结果85例患者服用噻氯匹定后行冠状动脉造影示冠状动脉造影阳性45例,其血小板膜CD62P16.11%±5.32%较服药前18.32%±6.12%差别无显著性意义(t=1.563,P>0.05);CD63表达阳性率26.43%±8.99%较服药前30.45%±8.21%差别也无显著性意义(t=1.581,P>0.05)。冠状动脉造影阴性者为40例,其血小板膜CD62P3.25%±1.13%较服药前3.85%±1.01%差别无显著性意义(t=1.131,P>0.05);CD63表达阳性率5.33%±1.32%较服药前6.01%±1.58%差别也无显著性意义(t=1.281,P>0.05)。结论为了进一步抑制急性冠脉综合征患者血小板活化状态,短期仅服用噻氯匹定片250mg,2次/d加阿斯匹林100mg,1次/d,3d,疗程可能偏短。

Objective To investigate the intervention of Ticlide on platelet activation in acute coronary syndrome (ACS). Methods The platelet membrane glycoproteins CD62P and CD63 were measured by flow cytometry in 85 patients with suspected acute coronary syndrome during the admission. Ticlide 250mg b.i.d and Aspirin 100mg q.d were given to all patients. CD62P and CD63 were measured 3 days after treatment. Results The activation states (CD62P and CD63) of the platelet were not significantly changed both for confirmed ACS and non-ACS patients after the administration of Ticlide for 3 days: in confirmed ACS patients CD62P was 16.11%±5.32% vs18.32%±6.12% (t=1.563, P>0.05), CD63 was 26.43%±8.99% vs 30.45%±8.21% (t=1.581, P>0.05); in non-ACS patients CD62P was 3.25%±1.13% vs 3.85%±1.01% (t=1.563, P>0.05), CD63 was 5.33%±1.32% vs 6.01%±1.58% (t=1.581, P>0.05). Conclusions The short course of Ticlide and Aspirin treatment seems to be not sufficient to inhibit the platelet activation in ACS patients.