噻氯吡啶对冠心病患者血小板聚集及血浆纤维蛋白原水平的影响

EFFECTS OF TICLOPIDINE ON PLATELET AGGREGATION AND PLASMA FIBRINOGEN LEVEL IN PATIENTS WITH CORONARY ARTERY DISEASE

本研究对冠心病患者应用噻氯吡啶对血小板聚集功能（ｐｌａｔｅｌｅｔａｇｇｒｅｇａｔｉｏｎ，ＰＡｇ）及血浆纤维蛋白原（ｆｉｂｒｉｎｏｇｅｎ，Ｆｇ）水平的影响进行探讨并与乙酰水杨酸（ａｃｅｔｙｌｓａｌｉｃｙｌｉａａｃｉｄ，ＡＳＡ）进行比较。冠心病（ｃｏｒｏｎａｒｙａｒｔｅｒｙｄｉｓｅａｓｅ，ＣＡＤ）患者１２０例，随机分为三组，即乙酰水杨酸组、噻氯吡啶组及对照组。噻氯吡啶组患者服用噻氯吡啶（抵克力得，ＴＩＣＬＩＤ）２５０ｍｇ，每日一次，连用４周；乙酰水杨酸组患者口服乙酰水杨酸７５ｍｇ，每日一次，连用４周。对照组患者于受试前２周内未服用抗血小板制剂。两用药组及对照组均于晨间空腹抽取静脉血，测定ＰＡｇ及Ｆｇ水平。用药组于用药４周末测定上述指标。ＰＡｇ测定采用比浊法，聚集诱导剂分别为肾上腺素（ｅｐｉｎｅｐｈｒｉｎｅ，Ｅｐｎ），二磷酸腺苷（ａｄｅｎｏｓｉｎｅｄｉｐｈｏｓｐｈａｔｅ，ＡＤＰ）及胶原（ｃｏｌａｇｅｎ，Ｃｏｌ），ＰＡｇ以加用诱导剂后５ｍｉｎ血小板聚集率表示。统计学处理，各组间比较采用ｓｔｕｄｅｎｔＴ检验，Ｐ＜０．０５为差异显著。结果表明，与对照组相比，乙酰水杨酸及噻氯吡啶组ＡＤＰ、肾上腺素及胶原诱导的ＰＡｇ均明显?

The effects of ticlopidine on platelet aggregation(PAg) and plasma fibrinogen(Fg) level were investigated and compared with those of acetylsalicylic acid(ASA) in patients with coronary artery disease(CAD). A total of 120 patients with CAD were randomly assigned into 3 groups, i.e. control (n=38), ticlopidine (TCP, n=42), and ASA(n=40) groups. The patients in TCP group were given TCP(TICLID) 250 mg, once daily for 4 weeks, and the patients in ASA group given ASA 75 mg, once daily for 4 weeks. The patients in the control group had not taken antiplatelet agents 2 weeks before blood sampling. Fast venous blood samples were taken in the morning in all the patients of the 3 groups for the measurement of PAg and Fg level. Blood samples were taken at the end of 4 weeks therapy in TCP and ASA groups. PAgs induced by adenosine diphosphate(ADP), epinephrine (Epn), and collagen(Coll) were measured by turbidometric aggregometer. Student T-test was used as the statistical method. The results showed that PAgs induced by ADP, Epn and Coll were significantly decreased in patients of both TCP and ASA groups compared with those of the control group. Inhibition of Epn-induced and Coll-induced PAgs by TCP was less than that by ASA, while inhibition of ADP-induced PAg was similar in both groups. However, Fg level of the patients in TCP group was significantly lower than those of patients in both control and ASA groups. It is concluded that both ticlopidine and acetylsalicylic acid could significantly inhibit the platelet aggregation and ticlopidine could also decrease the plasma fibrinogen level of patients with CAD.