Ketsa-Ard K, Poungvarin N, Juengchareon M, Jarerat S, Kittigul L
Department of Pharmacology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1991 Jun;74(6):331-9.
The investigators conducted a clinical study on antithrombotic effectiveness in ischemic stroke at Siriraj Hospital Medical School, Mahidol University from May 1987 to May 1989. Twenty-nine patients, 16 males and 13 females were enrolled in the study. The ages of the patients ranged from 30-87 years with a mean age of 63 +/- 11 years. Ticlopidine (250 mg) could significantly inhibit platelet aggregation induced by ADP and collagen within 24 hours of drug administration. After 1 week to 6 months, only aggregation by ADP was still inhibited significantly without significant effects on fibrinolytic activity and prostacyclin. Hematocrit was significantly decreased at the 1st and 2nd month of treatment. Serious side effects were skin rash and severe headache while the other common ones were dizziness, and diarrhea but these effects disappeared without discontinuing the drug. Most patients who suffered from nausea, diarrhea and headache, had temporary elevated SGPT. It may be concluded that only half of the recommended dose of ticlopidine has inhibitory effects on both phases of ADP-induced aggregation without interfering with fibrinolytic activity and can maintain prostacyclin. However, it also possesses either serious or common side-effects. This drug, therefore, should be used with the awareness of the clinician.
1987年5月至1989年5月，研究人员在玛希隆大学诗里拉吉医院医学院开展了一项关于缺血性卒中抗血栓疗效的临床研究。29名患者参与了该研究，其中16名男性，13名女性。患者年龄在30至87岁之间，平均年龄为63±11岁。噻氯匹定（250毫克）在给药后24小时内可显著抑制由二磷酸腺苷（ADP）和胶原蛋白诱导的血小板聚集。1周后至6个月时，仅对ADP诱导的聚集仍有显著抑制作用，对纤溶活性和前列环素无显著影响。治疗第1个月和第2个月时，血细胞比容显著降低。严重副作用为皮疹和严重头痛，其他常见副作用为头晕和腹泻，但这些副作用在不停药的情况下会消失。大多数出现恶心、腹泻和头痛的患者，血清谷丙转氨酶（SGPT）暂时升高。可以得出结论，仅推荐剂量一半的噻氯匹定对ADP诱导聚集的两个阶段均有抑制作用，且不干扰纤溶活性并能维持前列环素水平。然而，它也有严重或常见的副作用。因此，临床医生在使用这种药物时应有所注意。
