Ciuffetti G, Lombardini R, Pirro M, Lupattelli G, Mannarino E
Internal Medicine, Angiology and Arteriosclerosis Diseases Department, University of Perugia, Italy.
Clin Hemorheol Microcirc. 2001;25(1):31-9.
The usefulness of Clopidogrel as inhibitor of platelet aggregation has been demonstrated, but its effect on hemoreological parameters, such as whole blood viscosity at low and high shear rate, red cell aggregation and deformability indexes, filterability rate and and deformability of red blood cells has not been studied. This study revealed that, in subjects with impaired blood rheology and ultrasound evidence of atherosclerosis, 3-weeks treatment with clopidogrel (75 mg daily) improved blood viscosity at high shear rate and other hemorheological parameters, including red cell filterability rates and dynamic red cell deformability index (p<0.01 for all), without any unwanted side effect. Blood viscosity at low shear rate and red cell aggregation index improved after only 1-week treatment, and the reductions were mantained after two and three weeks (p<0.01). These results indicate that, similarly to another thienopyridine such as ticlopidine, Clopidogrel may have a positive influence on several hemorheological parameters, thus exerting its protection not only through inhibition of platelet function, but also through changes in the hemorheological profile.
氯吡格雷作为血小板聚集抑制剂的效用已得到证实,但其对血液流变学参数的影响,如低、高剪切速率下的全血粘度、红细胞聚集和变形性指标、滤过率以及红细胞变形性等尚未得到研究。本研究表明,在血液流变学受损且有动脉粥样硬化超声证据的受试者中,为期3周的氯吡格雷(每日75毫克)治疗改善了高剪切速率下的血液粘度以及其他血液流变学参数,包括红细胞滤过率和动态红细胞变形性指标(所有参数p<0.01),且无任何不良副作用。仅1周治疗后,低剪切速率下的血液粘度和红细胞聚集指数即有所改善,且在2周和3周后仍保持降低(p<0.01)。这些结果表明,与另一种噻吩吡啶类药物如噻氯匹定类似,氯吡格雷可能对多个血液流变学参数产生积极影响,从而不仅通过抑制血小板功能,还通过改变血液流变学特征发挥其保护作用。