Randi M L, Fabris F, Crociani M E, Battocchio F, Girolami A
Arzneimittelforschung. 1985;35(12):1847-9.
Ten patients with peripheral atherosclerotic disease(PAD) treated with 750 mg/d of 5-(2-chlorophenylmethyl)-4,5,6,7-tetrahydrothieno (3,5-c-pyridine) hydrochloride (ticlopidine, Tiklid) were studied for three months. As control was studied a similar group of patients treated with a traditional vasodilator (nicotinate). The aim of our study was to evaluate the effect of ticlopidine both on the clinical evolution of the disease and on rheologic, coagulative and platelet parameters. A progressive increase of maximal walking distance was noted during the three months of therapy with ticlopidine and limited to the first 30 days of treatment with nicotinate. The fibrinogen levels resulted significantly lowered during 90 days of treatment with ticlopidine, while that was not evident in the nicotinate group. There was also a slight improvement of blood viscosity in the ticlopidine group (not evident in the nicotinate group), but it was not statistically significant. No further modifications of investigated data were found in the two groups of patients. The clinical benefit of ticlopidine in PAD without adverse reactions can be confirmed at least at the dosage of 750 mg/d instead of the usual dose of 500 mg/d. A direct or indirect action of ticlopidine on plasma fibrinogen is suggested. This observation may supply new clues for the understanding of the mechanism of action of this drug.
对10例外周动脉粥样硬化疾病（PAD）患者给予每日750毫克的5 - （2 - 氯苯甲基）-4,5,6,7 - 四氢噻吩并[3,5 - c]吡啶盐酸盐（噻氯匹定，抵克立得）进行了为期三个月的研究。作为对照，研究了一组接受传统血管扩张剂（烟酸酯）治疗的类似患者。我们研究的目的是评估噻氯匹定对疾病临床进展以及血液流变学、凝血和血小板参数的影响。在使用噻氯匹定治疗的三个月期间，最大行走距离逐渐增加，而使用烟酸酯治疗仅限于前30天。在使用噻氯匹定治疗90天时，纤维蛋白原水平显著降低，而在烟酸酯组中不明显。噻氯匹定组的血液粘度也有轻微改善（烟酸酯组不明显），但无统计学意义。两组患者未发现其他研究数据的改变。至少在每日750毫克的剂量下，而非通常的500毫克/天剂量，可以证实噻氯匹定对PAD有临床益处且无不良反应。提示噻氯匹定对血浆纤维蛋白原有直接或间接作用。这一观察结果可能为理解该药物的作用机制提供新线索。
