[抗血小板药物对急性脑梗死患者血小板-白细胞聚集的影响及变化]

[The changes and effects of antiplatelet agents on platelet-leukocyte aggregation in patients with acute cerebral infarction].

作者信息

Wang Yin-ming, Cao Yong-jun, Liu Chun-feng, Feng Ping

机构信息

Department of Neurology, the Second Affiliated Hospital of Suzhou University, Suzhou 215004, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2007 Jul;46(7):562-5.

PMID:17959080

Abstract

OBJECTIVE

To investigate the changes of platelet-leukocyte aggregation (PLA) in patients with cerebral infarction and the effects of antiplatelet agents on it.

METHODS

The levels of plasma soluble P-selectin (sP-sel), serum C-reactive protein (CRP), platelet aggregation rate (PAR) and PLA were measured in 40 patients with acute cerebral infarction and 20 cases of controls. The 40 patients with cerebral infarction were randomly divided into aspirin-treated group (20 cases) and clopidogrel-treated group (20 cases) scandinavian neurological stroke score (SNSS), plasma sP-sel, serum CRP, PAR and PLA were observed before and after the treatment.

RESULTS

Compared with controls, the percentage of monocyte-platelet aggregation (PMA) was significantly increased in the patients (P < 0.001). The level of plasma sP-sel, serum CRP and PAR in the case group were significantly greater than those in the control group (P < 0.05). The level of PMA was positively related with the plasma sP-sel, serum CRP and PAR in cerebral infarction patients before treatment (P < 0.05), and it showed a significant inverse correlation between the percentage of PMA and the score of SNSS (P < 0.05). After treatment, the levels of PMA and PAR were decreased in both groups of cerebral infarction patients (P < or = 0.001), and the level of PMA and PAR (ADP) in clopidogrel-treated group was lower than those in aspirin-treated group (P < 0.05). However, the CRP in the patients was no significant difference before and after treatment. The level of sP-sel was no significant difference before and after treatment in aspirin-treated group, but it was significantly decreased after treatment in clopidogrel-treated group (P < 0.001).

CONCLUSIONS

The levels of PMA in patients with cerebral infarction was significantly higher than in the controls. PMA may be a sensitive marker of platelet activation. Aspirin and Clopidogrel could decline the level of PMA in the patients with acute cerebral infarction, and Clopidogrel was more effective than aspirin in inhibiting the activation of platelet.

摘要

目的

探讨脑梗死患者血小板 - 白细胞聚集（PLA）的变化以及抗血小板药物对其的影响。

方法

检测40例急性脑梗死患者和20例对照组的血浆可溶性P - 选择素（sP - sel）水平、血清C反应蛋白（CRP）、血小板聚集率（PAR）和PLA。将40例脑梗死患者随机分为阿司匹林治疗组（20例）和氯吡格雷治疗组（20例），观察治疗前后斯堪的纳维亚神经卒中评分（SNSS）、血浆sP - sel、血清CRP、PAR和PLA。

结果

与对照组相比，患者中单核细胞 - 血小板聚集（PMA）百分比显著升高（P < 0.001）。病例组血浆sP - sel、血清CRP和PAR水平显著高于对照组（P < 0.05）。治疗前脑梗死患者PMA水平与血浆sP - sel、血清CRP和PAR呈正相关（P < 0.05），且PMA百分比与SNSS评分呈显著负相关（P < 0.05）。治疗后，两组脑梗死患者PMA和PAR水平均降低（P ≤ 0.001），氯吡格雷治疗组PMA和PAR（ADP）水平低于阿司匹林治疗组（P < 0.05）。然而，患者治疗前后CRP无显著差异。阿司匹林治疗组治疗前后sP - sel水平无显著差异，但氯吡格雷治疗组治疗后显著降低（P < 0.001）。