中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
4期
363-366
,共4页
张波涛%张学虎%马列%马萍%马巧红%陶明莉%徐清斌
張波濤%張學虎%馬列%馬萍%馬巧紅%陶明莉%徐清斌
장파도%장학호%마렬%마평%마교홍%도명리%서청빈
冠状动脉粥样硬化性心脏病%氯吡格雷%CD62p%血小板活化
冠狀動脈粥樣硬化性心髒病%氯吡格雷%CD62p%血小闆活化
관상동맥죽양경화성심장병%록필격뢰%CD62p%혈소판활화
Coronary heart disease%Clopidogrel%CD62p%Platelet activation
目的 观察不同剂量氯吡格雷对冠状动脉粥样硬化性心脏病(冠心病)患者血清CD62p水平的影响.方法 选择观察对象191例,其中稳定型心绞痛(SAP)患者95例,非ST段抬高型急性冠状动脉综合征(NST-ACS)患者66例,SAP患者随机分为A组(48例)、B组(47例),NST-ACS患者随机分成C组(33例)、D组(33例),健康对照人群30名为E组.A组确诊后给予氯吡格雷75 mg/d,B组确诊后给予氯吡格雷150 mg/d;C组确诊后立即给予负荷剂量氯吡格雷300 mg,后予维持量75 mg/d,D组确诊后立即给予负荷剂量氯吡格雷300 mg,后予维持量150 mg/d.分别于服药前、服用负荷剂量氯吡格雷24h、服用氯吡格雷第5天抽取外周静脉血,应用酶联免疫吸附试验法测定血清CD62p的浓度.结果 (1)服药前血清CD62p的浓度:SAP患者[A组(7.62±2.99) ng/L、B组(8.48±3.13) ng/L]和NST-ACS患者[C组(9.50±3.32) ng/L、D组(10.22±5.14) ng/L]均高于健康对照者[(E组(5.49±1.99)ng/L,P均＜0.01],且NST-ACS患者高于SAP组患者(P＜0.05).(2)SAP患者服药后第5天血清CD62p浓度[(A组(6.79±2.51) ng/L、B组(6.37±1.80) ng/L]均较服药前[A组(7.62±2.99) ng/L、B组(8.48±3.13) ng/L]降低(t=2.390、t=4.520,P＜0.05和P＜0.01),且两组患者服药后血清CD62p浓度相比较差异无统计学意义(P均＞0.05).(3)C、D两组患者服药后第5天血清CD62p浓度[C组(8.21±2.62) ng/L、D组(8.17±2.37) ng/L均明显低于服药前[C组(9.50±3.32) ng/L、D组(10.22±5.14) ng/L],差异有统计学意义(t值分别为2.084、2.157,P均＜0.05),且两组患者服药后血清CD62p浓度比较差异无统计学意义(P＞0.05).结论 冠心病患者血清CD62p水平高于健康人群,服用氯吡格雷可降低冠心病患者的血清CD62p水平.
目的 觀察不同劑量氯吡格雷對冠狀動脈粥樣硬化性心髒病(冠心病)患者血清CD62p水平的影響.方法 選擇觀察對象191例,其中穩定型心絞痛(SAP)患者95例,非ST段抬高型急性冠狀動脈綜閤徵(NST-ACS)患者66例,SAP患者隨機分為A組(48例)、B組(47例),NST-ACS患者隨機分成C組(33例)、D組(33例),健康對照人群30名為E組.A組確診後給予氯吡格雷75 mg/d,B組確診後給予氯吡格雷150 mg/d;C組確診後立即給予負荷劑量氯吡格雷300 mg,後予維持量75 mg/d,D組確診後立即給予負荷劑量氯吡格雷300 mg,後予維持量150 mg/d.分彆于服藥前、服用負荷劑量氯吡格雷24h、服用氯吡格雷第5天抽取外週靜脈血,應用酶聯免疫吸附試驗法測定血清CD62p的濃度.結果 (1)服藥前血清CD62p的濃度:SAP患者[A組(7.62±2.99) ng/L、B組(8.48±3.13) ng/L]和NST-ACS患者[C組(9.50±3.32) ng/L、D組(10.22±5.14) ng/L]均高于健康對照者[(E組(5.49±1.99)ng/L,P均＜0.01],且NST-ACS患者高于SAP組患者(P＜0.05).(2)SAP患者服藥後第5天血清CD62p濃度[(A組(6.79±2.51) ng/L、B組(6.37±1.80) ng/L]均較服藥前[A組(7.62±2.99) ng/L、B組(8.48±3.13) ng/L]降低(t=2.390、t=4.520,P＜0.05和P＜0.01),且兩組患者服藥後血清CD62p濃度相比較差異無統計學意義(P均＞0.05).(3)C、D兩組患者服藥後第5天血清CD62p濃度[C組(8.21±2.62) ng/L、D組(8.17±2.37) ng/L均明顯低于服藥前[C組(9.50±3.32) ng/L、D組(10.22±5.14) ng/L],差異有統計學意義(t值分彆為2.084、2.157,P均＜0.05),且兩組患者服藥後血清CD62p濃度比較差異無統計學意義(P＞0.05).結論 冠心病患者血清CD62p水平高于健康人群,服用氯吡格雷可降低冠心病患者的血清CD62p水平.
목적 관찰불동제량록필격뢰대관상동맥죽양경화성심장병(관심병)환자혈청CD62p수평적영향.방법 선택관찰대상191례,기중은정형심교통(SAP)환자95례,비ST단태고형급성관상동맥종합정(NST-ACS)환자66례,SAP환자수궤분위A조(48례)、B조(47례),NST-ACS환자수궤분성C조(33례)、D조(33례),건강대조인군30명위E조.A조학진후급여록필격뢰75 mg/d,B조학진후급여록필격뢰150 mg/d;C조학진후립즉급여부하제량록필격뢰300 mg,후여유지량75 mg/d,D조학진후립즉급여부하제량록필격뢰300 mg,후여유지량150 mg/d.분별우복약전、복용부하제량록필격뢰24h、복용록필격뢰제5천추취외주정맥혈,응용매련면역흡부시험법측정혈청CD62p적농도.결과 (1)복약전혈청CD62p적농도:SAP환자[A조(7.62±2.99) ng/L、B조(8.48±3.13) ng/L]화NST-ACS환자[C조(9.50±3.32) ng/L、D조(10.22±5.14) ng/L]균고우건강대조자[(E조(5.49±1.99)ng/L,P균＜0.01],차NST-ACS환자고우SAP조환자(P＜0.05).(2)SAP환자복약후제5천혈청CD62p농도[(A조(6.79±2.51) ng/L、B조(6.37±1.80) ng/L]균교복약전[A조(7.62±2.99) ng/L、B조(8.48±3.13) ng/L]강저(t=2.390、t=4.520,P＜0.05화P＜0.01),차량조환자복약후혈청CD62p농도상비교차이무통계학의의(P균＞0.05).(3)C、D량조환자복약후제5천혈청CD62p농도[C조(8.21±2.62) ng/L、D조(8.17±2.37) ng/L균명현저우복약전[C조(9.50±3.32) ng/L、D조(10.22±5.14) ng/L],차이유통계학의의(t치분별위2.084、2.157,P균＜0.05),차량조환자복약후혈청CD62p농도비교차이무통계학의의(P＞0.05).결론 관심병환자혈청CD62p수평고우건강인군,복용록필격뢰가강저관심병환자적혈청CD62p수평.
Objective To investigate the change of serum CD62p of coronary heart disease (CHD) patients after different doses of clopidogrel administration.Methods One hundred and ninety-one patients with CHD were selected as our subjects.Of which,95 cases were with SAP and 66 cases were with non ST segment elevation acute coronary syndrome (NST-ACS).SAP patients were randomly given clopidogrel at dose of 75 mg/d or 150 mg/d and served as A and B groups.NST-ACS patients were randomly given 300 mg clopidogrel,then randomly divided into C and D groups with sequentially taking clopidogrel at dose of 75 mg/d or 150 mg/d respectively.Thirty healthy peoples were served as E group without drug intervention.Concentrations of serum CD62p were detected by Elisa before taking clopidogrel,24 h and the fifty day of after taking clopidogrel.Results (1) Before taking clopidogrel,the serum concentrations of CD62p in CHD patients were higher (A group:(7.62 ± 2.99) ng/L,B group:(8.48 ± 3.13) ng/L,C group:(9.50 ± 3.32) ng/L,D group:(10.22 ± 5.14) ng/L than that of healthy control group ((5.49 ± 1.99) ng/L,P ＜ 0.05).The Serum CD62p levels in SAP patients were lower than that of NST-ACS patients (P ＜ 0.05).(2)The serum concentrations of CD62p in A and B groups at before taking clopidogrel were (7.62 ±2.99) ng/L and (8.48 ±3.13) ng/L respectively,higher than that four days after taking clopidogrel ((6.79 ± 2.51) ng/L,(6.37 ± 1.80) ng/L;t =2.390,4.520;P ＜0.05 or P ＜0.01).There was no statistical significant difference between A and B groups(P ＞0.05).(3) In C and D groups,the serum CD62p at before taking clopidogrel were (9.50 ±3.32) ng/L and (10.22 ±5.14) ng/L,higher than that after taking clopidogrel for four days ((8.21 ± 2.62) ng/L,(8.17 ± 2.37) ng/L; t =2.084,2.157 ; P ＜ 0.05).No significant difference was seen between C and D groups (P ＞ 0.05).Conclusion The serum CD62p in patients with CHD was higher than that in the healthy control.Clopidogrel administration can decrease serum CD62p in CHD patients.
