静脉注射肝素钠和达肝素钠对血小板激活影响的对比研究

目的了解肝素钠(UFH)与低分子肝素(LWMH)对血小板激活的影响有无差别。方法59例新入院冠心病患者,随机分为UFH组和达肝素钠组,分别于基线状态下、给药(UFH或达肝素钠5000 IU)后30 min、1 h取血,测定CD62P、GPⅡb/Ⅲa、血管性假血友病因子(vWF)。结果UFH组静脉给药后30 min GPⅡb/Ⅲa、血浆CD62P及vWF的水平均明显高于给药前(P<0.05);给药后1 h GPⅡb/Ⅲa及vWF的水平仍显著高于给药前(P<0.05);血浆CD62P的水平虽仍较给药前增高,但差异无统计学意义(P>0.05)。静脉给予达肝素钠5000 IU30min后GPⅡb/Ⅲa及血浆CD62P的水平均明显高于给药前(P<0.05),但在给药后1 h即与基线值差异无统计学意义(P>0.05);vWF的水平在给予达肝素钠后30 min、1 h均与给药前相比,差异无统计学意义(P>0.05)。结论静脉注射UFH及达肝素钠均可激活血小板;但达肝素钠对血小板活化的影响较小。

Comparison of low-molecular-weight heparin to unfractionated heparin on platelet activation

Objective To compare the platelet activation effect between Dalteparin(low-molecular-weight heparin,LMWH) and unfractionated heparin(UFH).Methods Fifty-nine newly admitted patients were enrolled in this study,and were randomly assigned to UFH group or Dalteparin group.Blood samples were obtained through venipuncture so as to measure the plasma CD62P,vWF and platelet membrane GP Ⅱb/Ⅲa at baseline,30 minutes and 1 hour after UFH(5000 IU) or Dalteparin(5000 anti-Xa IU) administration.Results UFH group had higher expression of platelet membrane GP Ⅱb/Ⅲa and higher CD62P and vWF levels compared to Dalteparin group at 30 minutes after corresponding drug administration(P<0.05).At 1 hour after corresponding drug administrations,no significant differences were found between the two groups with respect to the expression of GP Ⅱb/Ⅲa and plasma CD62P level(all P>0.05),while vWF level in UFH group was still significantly higher than that in Dalteparin group(P<0.05).Conclusion Both intravenous administration of UFH and Dalteparin can activate platelet,but UFH has a more significant effect than Dalteparin on platelet activation.