检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2015年
10期
1411-1413
,共3页
冠心病%氯吡格雷%血清sCD40L%血小板活性
冠心病%氯吡格雷%血清sCD40L%血小闆活性
관심병%록필격뢰%혈청sCD40L%혈소판활성
coronary heart disease%clopidogrel%serum Scd40L%platelet activation
目的：探析不同剂量氯吡格雷对冠心病患者血清可溶性白细胞分化抗原40配体（sCD40L）水平的影响，为临床确定最宜剂量治疗冠心病，预防心血管不良事件的发生提供参考。方法随机选取该院心血管内科2014年1～8月收治的128例冠心病患者，其中稳定型心绞痛（SAP）72例为Ⅰ组；将其随机分为Ⅰa、Ⅰb组，每组36例。非ST段抬高型急性冠脉综合征（NST‐ACS）56例为Ⅱ组；将其随机分为Ⅱa、Ⅱb组，每组28例，均给予300mg负荷量氯吡格雷后分别给予维持剂量75、150mg／d，7d为1疗程。选取同期体检健康志愿者30例为健康对照组，健康对照组不予药物干预。采用酶联免疫吸附试验测定治疗前、负荷剂量24h、用药后5d血清sCD40L水平。结果服药前4组sCD40L平均浓度均高于健康对照组，Ⅱ组sCD40L平均浓度高于Ⅰ组，差异均有统计学意义（P＜0．05）；Ⅰ组、Ⅱ组负荷24h和服药后sCD40L平均浓度明显低于服药前（P＜0．05），Ⅰa、Ⅰb组负荷量24h和服药后sCD40L水平均明显低于Ⅱa、Ⅱb组（P＜0．01）。结论冠心病患者血清sCD40L水平高于健康人群，服用氯吡格雷抑制血小板活化，降低血清sCD40L水平，符合剂量氯吡格雷抑制效果确切，对于SAP抑制效果更强。
目的：探析不同劑量氯吡格雷對冠心病患者血清可溶性白細胞分化抗原40配體（sCD40L）水平的影響，為臨床確定最宜劑量治療冠心病，預防心血管不良事件的髮生提供參攷。方法隨機選取該院心血管內科2014年1～8月收治的128例冠心病患者，其中穩定型心絞痛（SAP）72例為Ⅰ組；將其隨機分為Ⅰa、Ⅰb組，每組36例。非ST段抬高型急性冠脈綜閤徵（NST‐ACS）56例為Ⅱ組；將其隨機分為Ⅱa、Ⅱb組，每組28例，均給予300mg負荷量氯吡格雷後分彆給予維持劑量75、150mg／d，7d為1療程。選取同期體檢健康誌願者30例為健康對照組，健康對照組不予藥物榦預。採用酶聯免疫吸附試驗測定治療前、負荷劑量24h、用藥後5d血清sCD40L水平。結果服藥前4組sCD40L平均濃度均高于健康對照組，Ⅱ組sCD40L平均濃度高于Ⅰ組，差異均有統計學意義（P＜0．05）；Ⅰ組、Ⅱ組負荷24h和服藥後sCD40L平均濃度明顯低于服藥前（P＜0．05），Ⅰa、Ⅰb組負荷量24h和服藥後sCD40L水平均明顯低于Ⅱa、Ⅱb組（P＜0．01）。結論冠心病患者血清sCD40L水平高于健康人群，服用氯吡格雷抑製血小闆活化，降低血清sCD40L水平，符閤劑量氯吡格雷抑製效果確切，對于SAP抑製效果更彊。
목적：탐석불동제량록필격뢰대관심병환자혈청가용성백세포분화항원40배체（sCD40L）수평적영향，위림상학정최의제량치료관심병，예방심혈관불량사건적발생제공삼고。방법수궤선취해원심혈관내과2014년1～8월수치적128례관심병환자，기중은정형심교통（SAP）72례위Ⅰ조；장기수궤분위Ⅰa、Ⅰb조，매조36례。비ST단태고형급성관맥종합정（NST‐ACS）56례위Ⅱ조；장기수궤분위Ⅱa、Ⅱb조，매조28례，균급여300mg부하량록필격뢰후분별급여유지제량75、150mg／d，7d위1료정。선취동기체검건강지원자30례위건강대조조，건강대조조불여약물간예。채용매련면역흡부시험측정치료전、부하제량24h、용약후5d혈청sCD40L수평。결과복약전4조sCD40L평균농도균고우건강대조조，Ⅱ조sCD40L평균농도고우Ⅰ조，차이균유통계학의의（P＜0．05）；Ⅰ조、Ⅱ조부하24h화복약후sCD40L평균농도명현저우복약전（P＜0．05），Ⅰa、Ⅰb조부하량24h화복약후sCD40L수평균명현저우Ⅱa、Ⅱb조（P＜0．01）。결론관심병환자혈청sCD40L수평고우건강인군，복용록필격뢰억제혈소판활화，강저혈청sCD40L수평，부합제량록필격뢰억제효과학절，대우SAP억제효과경강。
Objective To explore the effect of different dose of clopidogrel on serum sCD40L levels in patients with coronary heart disease for determining the most appropriate dose for clinical treatment of coronary heart disease and preventing cardiovascular adverse events .Methods A total of 128 coronary heart disease patients were selected randomly in this study from January to August 2014 ,72 patients with stable angina pectoris (SAP) were assigned into group Ⅰ ,then divided into group Ⅰa ,Ⅰb ,36 patients in each group .A total of 56 patients with non‐ST‐segment ele‐vation acute coronary syndrome(NST‐ACS) were selected into group Ⅱ ,then divided into group Ⅱa ,Ⅱb ,28 patients in each group .Group Ⅱa ,Ⅱ b were gave maintenance dose of clopidogrel as 75 ,150 mg/d respectively after giving loading dose clopidogrel as 300 mg/d ,seven days as a period treatment .A total of 30 healthy persons were recruited into control group ,and didn′t gave drug intervation .Enzyme‐linked immunosorbent assay were used to detected the serum level of sCD40L before treatment ,during 24 h after giving loading dose of clopidogrel and after treating 5 days .Results The average concentration of sCD40L in four groups were all higher than that in control group (P<0 .05) ,that of the group Ⅱ was higher than that of group Ⅰ(P<0 .05) .The level of sCD40L in group I and group Ⅱduring 24 h after taking the load dose of clopidogrel and after taking drug was significant lower than that before tak‐ing drug (P<0 .05) .The sCD40L levels in group Ⅰa ,Ⅰb during 24 h after taking the load dose of clopidogrel and after taking drug were significant lower than those of group Ⅱa ,Ⅱb (P<0 .01) .Conclusion Serum sCD40L level in patients with coronary heart disease is higher than that in healthy population ,clopidogrel could inhibit platelet activa‐tion ,reduce serum sCD40L level ,the inhibit effect of load dose of clopidogrel is sure ,the inhibition effect of it is stronger for SAP .
