Fukaya S, Iwamoto T, Kin K, Takasaki M
Department of Geriatric Medicine, Tokyo Medical University.
Nihon Ronen Igakkai Zasshi. 2000 Aug;37(8):619-26. doi: 10.3143/geriatrics.37.619.
To clarify the factors influencing platelet function in elderly patients with chronic thrombotic disease, platelet aggregability was studied in 839 blood samples from 497 patients with a variety of diseases. Clinical stage (thrombotic disease), vascular risk factors, and data concerning any administration of antiplatelet drugs were assessed, as well as brain computerized tomographic and carotid ultrasonographic findings. Platelet aggregability was determined spectrophotometrically with an aggregometer (PAM-8T) and adenosine-5'-diphosphate as an agonist to determine new parameters: the grading curve (GC) type, and platelet aggregability threshold index (PATI). Multiple regression analysis showed that the antiplatelet therapy greatly influenced the GC type. Platelet aggregability, which accelerated with aging, was strongly suppressed by ticlopidine. Furthermore, excluding samples with antiplatelet therapy, statistical analysis showed that platelet aggregability was accelerated in women, and in patients with bilateral or complicated carotid lesions, although these patients were significantly older than the others. These findings suggested that accelerated aggregability in the elderly substantially reflected the progress of arteriosclerosis with age. Moreover, the findings indicated that the determination of GC type and PATI were useful in monitoring elderly patients receiving antiplatelet therapy, especially with ticlopidine.
为阐明影响老年慢性血栓性疾病患者血小板功能的因素，对497例患有各种疾病患者的839份血样的血小板聚集性进行了研究。评估了临床分期（血栓性疾病）、血管危险因素以及任何抗血小板药物的使用数据，以及脑部计算机断层扫描和颈动脉超声检查结果。用聚集仪（PAM - 8T）通过分光光度法测定血小板聚集性，并以5'-二磷酸腺苷作为激动剂来确定新参数：分级曲线（GC）类型和血小板聚集性阈值指数（PATI）。多元回归分析表明，抗血小板治疗对GC类型有很大影响。随着年龄增长而加速的血小板聚集性被噻氯匹定强烈抑制。此外，排除接受抗血小板治疗的样本后，统计分析表明，女性以及患有双侧或复杂性颈动脉病变的患者血小板聚集性加速，尽管这些患者比其他患者年龄明显更大。这些发现表明，老年人中加速的聚集性在很大程度上反映了动脉硬化随年龄的进展。此外，这些发现表明，GC类型和PATI的测定对于监测接受抗血小板治疗，尤其是接受噻氯匹定治疗的老年患者是有用的。
