双重抗血小板治疗对急性脑梗死患者血小板活化及聚集的影响

Influence of aspirin combined with Ginkgo leaf extract and dipyridamole injection on the activation and aggregation of platelets in patients with acute cerebral infarction

目的观察急性脑梗死患者血小板CD62p表达及血小板聚集的变化,并探讨双重抗血小板治疗对其的影响。方法将60例急性脑梗死患者随机分为阿司匹林治疗组(A组)和阿司匹林+银杏达莫注射液治疗组(B组),每组各30例。采用流式细胞技术,于发病次日及治疗2周后对血小板CD62p的表达进行检测,并观察2组患者治疗前后Scandinavian卒中量表(SNSS)评分、血小板聚集率(PAR)的变化。结果与治疗前比较,2组治疗后PAR(ADP)、PAR(AA)、CD62p均显著降低,差异有统计学意义(P<0.01);2组治疗后SNSS评分均高于治疗前,差异有统计学意义(P<0.05);2组治疗后比较,B组PAR(ADP)、CD62p低于A组,差异有统计学意义(P<0.01)。结论与单用阿司匹林相比,阿司匹林联用银杏达莫注射液具有更强的抑制血小板活化及聚集的作用。

Objective To observe the changes of platelet activity （expressed by CD62p） and platelet aggregation rate （PAR） in patients with cerebral infarction, as well as to explore the effects of aspirin combined with Ginkgo leaf extract and dipyridamole injection on the activation and aggregation of platelets. Methods Sixty patients with acute cerebral infarction were randomly divided into two groups：group A（30 cases）, treated with aspirin（0, 1 g/d） ;group B（30 cases）, treated with aspirin（0, 1g/d） and Ginkgo leaf extract and dipyridamole injection. The level of CD62p expression （using flow eytometry method）and PAR were measured before and after treatment. Scandinavian stroke score （SNSS） was introduced to evaluate the clinical efficiency. Results After treatment, the percentage of PAR（ADP）, PAR（AA） and CD62p were decreased in both groups（P 〈0.01）. The score of SNSS was significantly increased in both groups after treatment, but there was no difference in score of SNSS between group A and group B either before or after treatment. The percentage of PAR（ADP） and CD62p in group B were lower than that in group A after treatment （P〈0.01）. Conclusion The activation and aggregation of platelet in patients with cerebral infarction may be significantly suppressed by aspirin combined with Ginkgo leaf extract and dipyridamole injection, which is better than the effect of aspirin alone.