CAJ | 학술논문

目的观察阿托伐他汀合用抗血小板药物及抗凝药物后对血浆血小板膜糖蛋白140(GMP-140)和纤维蛋白肽A(FPA)的影响. 方法选择需他汀类药物治疗的高胆固醇血症患者(高脂血症组)50例,在他汀类药物(阿托伐他汀20 mg/d,共6周)使用前、后测定GMP-140和FPA水平及血胆固醇、肝功能、血常规、血凝常规等指标;选择低密度脂蛋白胆固醇低于2.1 mmol/L的冠心病患者50例,应用抗血小板药物和抗凝药物作为对照组;另外选择需他汀类药物治疗的冠心病患者(治疗组)50例,合用抗血小板药物和抗凝药物为研究对象,使用阿托伐他汀20 mg/d 6周,在用药前、后测定GMP-140和FPA水平及血胆固醇水平、肝功能、血常规、血凝常规等指标. 结果高脂血症组患者入院时GMP-140 (61.9±6.3)μg/L、FPA(53.5±6.1) μg/L,阿托伐他汀治疗6周后血GMP 140(51.2±4.1)μg/L、FPA(42.9±4.2) μg/L,差异有统计学意义(均P＜0.01);对照组患者入院时血GMP-140 (81.5±11.1)μg/L、FPA(100.7±10.6) μg/L,常规抗血小板和抗凝治疗后,血GMP 140(76.3±9.7) μg/L、FPA(96.5±5.8) μg/L(均P＜0.05);治疗组患者入院时血GMP140(81.2±15.1) μg/L、FPA(99.0±10.9)μg/L,常规抗血小板及抗凝治疗基础上增加阿托伐他汀治疗后,GMP-140、FPA分别为(71.5±12.3)μg/L、(86.4±6.1)μg/L,与治疗前比较差异有统计学意义(均P＜0.01);入院时,对照组与治疗组患者的血GMP-140和FPA水平比较差异无统计学意义,两组患者在治疗6周后血GMP-140和FPA水平下降,但与对照组相比较,治疗组患者的血GMP 140和FPA水平下降更明显(均P＜0.01). 结论阿托伐他汀能降低GMP-140和FPA水平,合用抗血小板药物及抗凝药物后,能进一步降低GMP-140和FPA水平.
목적 관찰아탁벌타정합용항혈소판약물급항응약물후대혈장혈소판막당단백140(GMP-140)화섬유단백태A(FPA)적영향. 방법 선택수타정류약물치료적고담고순혈증환자(고지혈증조)50례,재타정류약물(아탁벌타정20 mg/d,공6주)사용전、후측정GMP-140화FPA수평급혈담고순、간공능、혈상규、혈응상규등지표;선택저밀도지단백담고순저우2.1 mmol/L적관심병환자50례,응용항혈소판약물화항응약물작위대조조;령외선택수타정류약물치료적관심병환자(치료조)50례,합용항혈소판약물화항응약물위연구대상,사용아탁벌타정20 mg/d 6주,재용약전、후측정GMP-140화FPA수평급혈담고순수평、간공능、혈상규、혈응상규등지표. 결과 고지혈증조환자입원시GMP-140 (61.9±6.3)μg/L、FPA(53.5±6.1) μg/L,아탁벌타정치료6주후혈GMP 140(51.2±4.1)μg/L、FPA(42.9±4.2) μg/L,차이유통계학의의(균P＜0.01);대조조환자입원시혈GMP-140 (81.5±11.1)μg/L、FPA(100.7±10.6) μg/L,상규항혈소판화항응치료후,혈GMP 140(76.3±9.7) μg/L、FPA(96.5±5.8) μg/L(균P＜0.05);치료조환자입원시혈GMP140(81.2±15.1) μg/L、FPA(99.0±10.9)μg/L,상규항혈소판급항응치료기출상증가아탁벌타정치료후,GMP-140、FPA분별위(71.5±12.3)μg/L、(86.4±6.1)μg/L,여치료전비교차이유통계학의의(균P＜0.01);입원시,대조조여치료조환자적혈GMP-140화FPA수평비교차이무통계학의의,량조환자재치료6주후혈GMP-140화FPA수평하강,단여대조조상비교,치료조환자적혈GMP 140화FPA수평하강경명현(균P＜0.01). 결론 아탁벌타정능강저GMP-140화FPA수평,합용항혈소판약물급항응약물후,능진일보강저GMP-140화FPA수평.
Objective To investigate the effect of Atovastatin combined with conventional antiplatelet and anticoagulant drugs on the levels of platelet alpha-granule membrane glycoprotein 140 (GMP-140) and fibrinopeptide A (FPA).Methods 50 patients with hypercholesteremia received atovastatin 20mg/d for 6 weeks (atovastatin group).100 patients with coronary heart disease were randomly allocated into control group [patients with low density lipoprotein concentration＜2.1mmol/L,receiving conventional antiplatelet and anticoagulant drugs,n=50) and treatment group (receiving atovastatin 20mg/d for 6 weeks combined with conventional antiplatelet and anticoagulant drugs,n=50).The levels of GMP-140,FPA,and cholesterol,liver function,blood test and hemagglutination in the three groups were detected before and after treatment.Results Compared with pretreatment,GMP-140 and FPA levels were significantly decreased after 6 weeks of treatment in atovastatin,control group and treatment group [GMP-140:(61.9±6.3)g/L vs.(51.2±4.1) g/L,(81.5±11.1) g/L vs.(76.3±9.7) g/L,(81.2±15.1) g/L vs.(71.5±12.3) g/L; FPA:(53.5±6.1) g/L vs.(42.9±4.2) g/L,(100.7±10.6) g/L vs.(96.5±5.8) g/L,(99.0±10.9) g/L vs.(86.4±6.1) g/L,P＜0.01 or P＜0.05].There were no significant differences in the levels of GMP-140 and FPA between the control and treatment groups before treatment,while after 6 weeks of treatment,the changes in the levels of GMP-140 and FPA were much more in treatment group than in control group (both P＜0.01).Conclusions Atovastatin can significantly decrease the levels of GMP-140 and FPA,especially in combination with conventional antiplatelet and anticoagulant drugs.