抵克力得、阿司匹林对糖尿病患者高纤维蛋白原血症影响的比较

Comparison of effects of ticlid and aspirin on hyperfibrinogenemia in type 2 diabetic patients

目的观察抵克力得(T组)、阿司匹林(A组)对糖尿病(DM)高纤维蛋白原(FG)血症的治疗作用和副作用。方法选择无明显异常心电图和感染及脑梗死病史的DM高FG血症患者473例,随机分为两组,分别予抵克力得、阿司匹林治疗,以脑或心肌或皮肤梗死、出血倾向、白细胞减少事件为观察终点,治疗时间8～47个月,观察两组FG等炎性因子和临床终点事件的发生情况。结果T组的FG、WBC、hsC-RP明显降低,而A组则无明显变化;T组病人的心、脑、皮肤梗死和消化道、牙龈、皮肤出血倾向较A组病人明显减少;T组有6例发生白细胞减少症(A组0例),但均未发生粒细胞缺乏和感染,且停药或(和)集落细胞刺激因子等升白细胞治疗后缓解。结论与阿司匹林相比,抵克力得治疗DM高FG血症更有效,并明显减少患者的梗死和出血倾向,但白细胞减少事件明显多于使用阿司匹林。在不宜使用阿司匹林(如过敏等)的病例可小心试用抵克力得。

Objective To study the effects of ticlid and aspirin on hyperfibrinogenemia in diabetic patients. Methods 473 diabetic patients with hyperfibrinogenemia and without obvious abnormal EKG, infections and brain infarction were randomly divided into T（ticlid） and A（aspirin） groups and treated with ticlid（121.9±23.7mg/day） and aspirin （113.7± 45.1 mg/day） respectively for 8-47 months（34. 9±14. 5）. The observation parameters included infarctions, bleeding, leucopenia, plasma fibrinogen （FG）, high sensitive C-responsive protein （hs-CRP） and white blood cells （WBC）. Results Compared with pretreatment, FG, hs-CRP and WBC in group T were decreased （P〈0. 001, 0. 05, 0. 001 respectively） while those in group A had no different change. And cases with infarction and bleeding were fewer （P〈0. 001） while leucopenia case was more in group T than in group A （P = 0. 000）. Leucopenia were all cured with G-CSF etc. Conclusions Ticlid is more effective against hyperfibrinogenemia in diabetic patients than is aspirin. We can administer ticlid to the patients not suitable for taking aspirin,but their WBC must be tested regularly.