噻氯匹定对脑梗死病人血小板聚集的影响

目的：观察噻氯匹定对急性脑梗死的治疗效果及其对血小板聚集的影响。方法：脑梗死病人１１９例，随机分成噻氯匹定组和基础治疗（右旋糖酐＿４０，三磷腺苷二钠，辅酶Ａ，胞磷胆碱等）对照组，观察疗效，并于治疗前、治疗７ｄ和１６ｄ后检测血小板聚集率。结果：噻氯匹定组有效率达９６％；明显降低血小板聚集率，较对照组有显著性差异。结论：噻氯匹定可用于脑梗死急性期的治疗，抑制血小板聚集是其重要的治疗机制。     

不同剂量阿司匹林对冠心病患者血小板聚集功能的影响

目的探讨不同剂量阿司匹林对冠心病患者血小板聚集功能（PAG）的抑制作用。方法 248例冠心病患者随机分为A组62例、B组62例、C组63例、D组61例,4组阿司匹林口服剂量分别为每天50mg、100mg、200mg、300mg,服药前及服药2周后测定PAG。结果用药前后相比,4组不同剂量阿司匹林（50,100,200,300mg）对PAG均有一定的抑制作用。B组对PAG的抑制作用与A组比较差异无统计学意义（P〉0.05）。C组、D组对PAG的抑制作用明显优于B组,差异有统计学意义（P〈0.05和P〈0.01）,但C组与D组比较,差异无统计学意义（P〉0.05）。结论阿司匹林每天200mg可能是一个较合理的治疗剂量。     

Platelet aggregation behaviour in patients treated with ticlopidine

Thirty patients (18 women, 12 men) with permanent or paroxysmal atrial fibrillation were treated with a new antiplatelet drug, ticlopidine, in order to study platelet aggregation behaviour, to see whether the drug prevents thromboembolisms and to observe side-effects over a period of 6 months. A further comparative study of the effects of ticlopidine and dipyridamole + aspirin on platelet aggregation was carried out in 20 patients. All appropriate haematological parameters were tested every 3 months, while platelet aggregation curves with ADP were examined also after 15 days. At the end of the period an echocardiogram was performed to check for any sign of thrombosis. The reduction in the aggregation curves was statistically significant for all the ADP stimuli, except at low doses. In the comparison with dipyridamole + aspirin, ticlopidine gave better results; with the former there was no significant reduction in platelet aggregation. A more significant reduction was seen in patients who had showed hyperaggregation at the outset. Bleeding time was increased and platelet adhesivity was reduced. During the 6-month period a slight reduction in white blood cells and a slight increase in creatinine were observed, both remaining within the normal range. Some 33.3% of the patients experienced side-effects. No embolic event or thrombosis in the left atrium was seen. Ticlopidine seems to be an effective antiplatelet drug, especially for patients with hyperaggregation.     

不同剂量阿司匹林对冠心病患者血小板聚集功能的影响

目的 探讨不同剂量阿司匹林对冠心病患者血小板聚集功能(PAG)的抑制作用.方法 248例冠心病患者随机分为A组62例、B组62例、C组63例、D组61例,4组阿司匹林口服剂量分别为每天50mg、100mg、200mg、300mg,服药前及服药2周后测定PAG.结果 用药前后相比,4组不同剂量阿司匹林(50,100,200,300mg)对PAG均有一定的抑制作用.B组对PAG的抑制作用与A组比较差异无统计学意义(P>0.05).C组、D组对PAG的抑制作用明显优于B组,差异有统计学意义(P<0.05和P<0.01),但C组与D组比较,差异无统计学意义(P>0 05).结论 阿司匹林每天200mg可能是一个较合理的治疗剂量.     

Effect of ildamen on the heart conduction system in ischemic heart disease patients

Thirty-four patients with ischemic heart disease (IHD) were studied: 18 IHD patients with latent forms of disturbances of conductivity in the atrioventricular junction and sinus node sickness syndrome revealed at frequency stimulation of the heart; 16 patients with acute myocardial infarction complicated with the atrioventricular junction blockade of II and III degrees. Ildamen solution (4 mg) was slowly intravenously infused to all patients under study. Exerting the beta-stimulating effect, ildamen positively influences restoration of the disordered function of the pacemaker and conduction system of the heart: through immediate action on these systems and an increase of the coronary blood flow contributing to improvement of nutrition of the condition system of the heart.     

硫酸氢氯吡格雷联合阿司匹林治疗老年冠心病对凝血指标、血小板聚集率的影响

目的探讨硫酸氢氯吡格雷联合阿司匹林肠溶片对老年冠心病患者凝血指标及血小板聚集率情况的影响。方法选择80例老年冠心病患者作为观察对象,以随机数字表法将患者分为阿司匹林组及联合组,每组40例,阿司匹林组接受阿司匹林肠溶片抗凝治疗,联合组接受硫酸氢氯吡格雷联合阿司匹林肠溶片抗凝治疗,分析两组治疗过程中凝血指标及血小板聚集率变化情况。结果两组治疗过程中,PT、APTT及INR呈升高趋势,FIB及PAR呈下降趋势(P<0.05),入组时及治疗7d时比较,两组间PT、APTT、INR、FIB及PAR比较,未见统计学差异(P>0.05),而在治疗14d及治疗28d时,联合组PT、APTT及INR高于阿司匹林组,FIB及PAR低于阿司匹林组(P<0.05)。同时,两组治疗过程中,药物不良反应发生率比较,无统计学差异(P>0.05)。结论在老年冠心病的治疗中硫酸氢氯吡格雷联合阿司匹林肠溶片可在不增加药物不良反应发生率的同时,有效的改善患者的凝血及血小板聚集率指标。     

Effect of trapidil on serum lipid and apolipoprotein levels in patients with ischemic heart disease

1. Serum total cholesterol (TCH), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein (LDL-C), atherosclerotic index (AI) and apolipoprotein (apo A-I, A-II, B, C-II, C-III and E) levels were investigated in patients with ischemic heart disease before and after medication of trapidil.2. Twenty-one patients were orally given 100 mg of trapidil, three times daily (300 mg/day). After 8 weeks' administration, serum HDL-C level increased (P < 0.001) and AI decreased (P < 0.02) significantly, whereas TCH, TG and LDL-C levels tended to decrease but not significantly.3. Among the parameters of apolipoproteins, apo A-I, a main protein of HDL-C, was significantly increased (P < 0.05) by trapidil.4. These results indicate that trapidil has a beneficial effect on the coronary risk profile as reflected by lipid measurements.     

Acupuncture may improve exercise tolerance in patients with heart failure

Kristen AV, Schumacher B, Strych K, Lossnitzer D, Friederich HC, Hilbel T, Haass M, Katus HA, Schneider A, Streitberger KM, Backs J. Acupuncture improves exercise tolerance of patients with heart failure: a placebo‐controlled pilot study. Heart 2010; 96: 1396–1400.     

Evaluation of platelet activation in depressed patients with ischemic heart disease after paroxetine or nortriptyline treatment

This study investigated the effects of antidepressant treatment on platelet activation in depressed patients with ischemic heart disease (IHD). Plasma levels of platelet alpha-granule release products beta-thromboglobulin (BTG) and platelet factor 4 (PF4) were measured in 17 depressed patients with IHD who were treated in a 6-week, double-blind trial with either paroxetine (10 patients) or nortriptyline (7 patients). Baseline measurements of BTG and PF4 were significantly elevated in both drug treatment groups before the initiation of antidepressant therapy compared with those of healthy control subjects. In the paroxetine group, mean PF4 and BTG levels significantly decreased from these elevated baseline values within 1 week of treatment and remained low at 3- and 6-week measurements. In contrast, the nortriptyline group did not exhibit a significant decrease in PF4 or BTG plasma levels after 1, 3, or 6 weeks of treatment. Therefore, platelet activation in depressed patients with IHD seems to be inhibited by the selective serotonin reuptake inhibitor paroxetine. The effect of paroxetine on PF4 and BTG plasma levels suggests that it may reduce platelet aggregation in vivo and may positively impact IHD-related mortality in this population.     

银杏达莫对缺血性脑血管病患者血液黏度及血小板聚集率水平的影响

目的：研究银杏达莫对缺血性脑血管病患者血液黏度及血小板聚集率的影响。方法选取2011年5月-2013年5月医院缺血性脑血管病的患者158例。随机分为观察组与对照组各79例。对照组予复方丹参注射液静脉滴注,观察组予银杏达莫注射液,其他治疗条件均相同。4周后检测、比较2组患者血液黏度指标和神经功能缺损情况。结果治疗后观察组血液黏度与血小板聚集率均较对照组下降快,且观察组治疗后的神经功能缺损亦比对照组低,差异有统计学意义（ P﹤0.05）。结论银杏达莫注射液不仅能明显减低患者血液黏度和血小板聚集率,还能有效降低神经功能缺损的评分,疗效好,安全性好,值得临床推荐。     

流式细胞术检测阿司匹林对冠心病患者血小板活化标志物的影响

目的：探讨冠心病患者及其服用阿司匹林前后血小板表面糖蛋白的变化及其意义。方法：采用流式细胞仪（flow cytometry，FCM）测定冠心病患者阿司匹林治疗前后的全血中血小板表面糖蛋白（CD62p／PAC-1）的表达率，采用自身对照分析阿司匹林对血小板表面糖蛋白的影响。结果：冠心病组治疗前的血小板表面糖蛋白PAC-1、CD62p的表达率分别为（10.4±6．2）％和（10．7±7．1）％，较健康对照组明显升高（P＜0．01）．经以阿司匹林为基础的抗血小板治疗后CD62p、PAC-1的表达率下降至（4．3±2．1）％和（4．9±2．4）％（P＜0．01），但仍高于健康对照组。结论：CD62p和PAC-1是血小板活化的敏感和特异指标，阿司匹林能够抑制血小板表面糖蛋白的表达．从而抑制血小板活化，抑制血栓形成。     

Effect of nifedipine on exercise tolerance in patients with angina pectoris

Summary To test if nifedipine, 10 mg sublingually, could increase exercise tolerance, ten patients with angina pectoris each performed two types of bicycle exercise test, one with a stepwise increase in load and the other with a continuously increasing load. The drug was given in a double-blind cross-over trial. Nifedipine raised the heart rate and diminished the systemic blood pressure at rest, on standing and during exercise at comparable loads. Work time was prolonged and higher work loads were achieved. The total work performed rose by 50 per cent in one of the tests and by 23 per cent in the other, about 50 minutes after taking the drug. The mechanism of the greater work capacity in angina pectoris after nifedipine was assumed to be diminished heart work due to a fall in systemic vascular resistance.Trade mark Adalat^®, Bayer A.G., Leverkusen, W. Germany     

蚓激酶多中心、双盲、安慰剂对照治疗缺血性脑血管病患者的实验室效果

目的：观察蚓激酶对缺血性脑血管病患者血液流变学及纤溶系统的影响及不良反应。方法：采用多中心、双盲、安慰剂对照的方法治疗缺血性脑血管病恢复期的患者285例。治疗组209例予蚓激酶430mg,tid；安慰剂组76例服安慰剂2粒，tid.疗程均为4周。结果：蚓激酶治疗可使血纤维蛋白原降低（P＜0．01），部分患者（43．1％）D二聚体转为阳性，血小板聚集率降低（P＜0．01）。对红细胞计数、血细胞比容、血小板计数也有轻度降低。不良反应发生率为3．83％。结论：蚓激酶可作为治疗和预防缺血性脑血管病的安全的药物之一。     

A lack of effect of captopril on platelet aggregation in patients with congestive heart failure

Summary We have studied the acute and chronic effects of an ACE inhibitor (captopril) on platelet function and the renin-angiotensin system in patients with congestive heart failure.Plasma concentrations of angiotensin II fell significantly after a single dose of captopril (25 mg) and during long-term treatment with captopril (2 weeks, 75 mg/day). Plasma renin activity increased significantly after both the single and repeated doses.Captopril did not affect ADP-induced platelet aggregation or concentrations. It seems unlikely that circulating angiotensin II affects ADP-induced platelet aggregation in patients with congestive heart failure.     

蝙蝠葛碱对急性心肌梗死患者血小板聚集性的影响

目的　探讨蝙蝠葛碱 (DAU )对急性心肌梗死 (AMI)患者血小板不可逆性聚集的作用。方法　用流式细胞仪测定AMI患者 (n =12 )静息状态及凝血酶 (5 0、10 0、5 0 0、10 0 0U·L-1)激活时 ,血小板膜表面糖蛋白Ⅳ (GPIV)及凝血酶敏感蛋白 (TSP )分布状况 ,并与健康人 (n =14)比较。结果　AMI患者静息及激活状态血小板膜表面GPⅣ ,TSP分布高于健康人 (P <0 0 5 ,0 0 1) ;DAU(5 0 μmol·L-1)可抑制 5 0U·L-1,10 0U·L-1及 5 0 0U·L-1凝血酶诱导的血小板膜GPⅣ再分布及血小板内TSP释放 (P <0 0 5 ,0 0 1) ,不能抑制10 0 0U·L-1凝血酶诱导的血小板膜GPⅣ再分布及血小板内TSP释放。结论　AMI患者血小板活性及对凝血酶的反应性增高 ,DAU可减少AMI患者血小板不可逆性聚集的发生。     

Effect of nifedipine monotherapy on platelet aggregation in patients with untreated essential hypertension

Summary The effect of 6 weeks of nifedipine 30–60 mg/d on platelet aggregation and lipid parameters has been studied.A diminution in ADP-, adrenaline- and collagen-induced aggregation was observed. In the case of adrenaline-and collagen-stimulated aggregation the decrease was statistically significant. It was found that platelets which aggregated markedly during the placebo treatment were most strongly inhibited by nifedipine. The changes in lipid parameters were not significantly correlated with changes in aggregation.This report is a part of a project realized within the frames of the government programme of studies of the side-effects of hypotensive drugs given for 1 year.     

The influence of combined treatment with propranolol and acetylsalicyclic acid on platelet aggregation in coronary heart disease

1 Antiaggregating agents are frequently prescribed alone or together with β-adrenergic receptor blocking agents in patients after myocardial infarction. The present study was designed to examine the effects of combined treatment with propranolol and acetylsalicylic acid (ASA) on platelet aggregability.

2 Spontaneous platelet aggregation and aggregation induced by fibrinogen and adrenaline were studied in a group of patients with coronary heart disease before treatment, after treatment with propranolol (0.75-1.0 mg/kg daily), and after combined treatment with propranolol in same dose and ASA (20-25 mg/kg daily). Twenty-one patients with stable angina pectoris and/or after myocardial infarction and twelve healthy men were included in the study.

3 There were no significant differences in both spontaneous and induced platelet aggregation between patient and control group before treatment. Propranolol influenced fibrinogen-induced aggregation: it lowered maximal amplitude of aggregation (P < 0.05), but it did not change the reaction time. ASA in combination with propranolol affected both spontaneous and induced aggregation: it diminished the number of pathological spontaneous aggregations (P < 0.025), it inhibited the second wave of adrenaline-induced aggregation (P < 0.01), prolonged the reaction time of fibrinogen-induced aggregation (P < 0.01) and lowered the maximal amplitude of aggregation (P < 0.05).

4 The study showed that propranolol besides its well-known hemodynamic effects had an additional antiaggregating property. The action of combined treatment with propranolol and ASA on platelet aggregation is probably additive.