氯吡格雷对不稳定型心绞痛患者血小板功能的影响

目的 :观察氯吡格雷对不稳定型心绞痛 （UAP）患者血小板功能的影响 ,探讨其临床应用价值。方法 :UAP患者 85例 ,随机分为氯吡格雷负荷剂量组 （n=30 ） ,氯吡格雷常规剂量组 （n=30 ）及噻氯匹定治疗组 （n=2 5 ）。所有患者在给予阿司匹林 30 0 mg/ d的基础上 ,氯吡格雷负荷剂量组 1次性给予氯吡格雷 （波立维 ） 30 0 mg,氯吡格雷常规剂量组给予波立维 75 mg/ d,噻氯匹定组给予噻氯匹定 （抵克力得 ） 2 5 0 mg/ d,观察 3组患者治疗前 ,氯吡格雷负荷剂量组给药 2 h后 ,氯吡格雷常规剂量组及噻氯匹定组给药 3d后患者血浆 GMP- 14 0含量及血小板最大聚集率（MPAR）的变化。结果 :各组患者治疗后血浆 GMP- 14 0含量及 MPAR较治疗前显著降低 （P<0 .0 1） ,组间血浆GMP- 14 0含量及 MPAR无显著性差异 （P>0 .0 5 ）。结论 :氯吡格雷起效迅速 ,首剂负荷剂量 30 0 mg服药后 2 h即可有效抑制血小板激活 ,可达到服用常规剂量氯吡格雷或噻氯匹定连续 3d抑制血小板激活的效果

Effect of clopidogrel on platelet function in patients with unstable angina pectoris

AIM:To investigate the effect of clopidogrel on platelet activation in patients with unstable angina pectoris(UAP), and to discuss its clinical value.METHODS:85 UAP patients were randomly divided into three groups: clopidogrel loading dose group( n =30),clopidogrel routine dose group( n =30) and ticlopidine group( n =25). All the patients were given aspirin 300 mg/d as the base treatment, then the colpidogrel loading group patients were given polivex bolus 300 mg;the clopidogrel routine dose group patients were given polivex 75 mg/d on 3 successive days and the ticlopidine group patients were given ticlid 250 mg/d on 3 successive days. 2 hours after the first drug intake of clopidogrel loading dose group, and 3 days after drug intake of clopidogrel routine dose group and ticlopidine group. Venous blood was sampled for the determination of markers of plasma GMP-140 and max platelet aggregation rate(MPAR) induced by ADP pre-treatment. RESULTS:At post-treatment plasma GMP-140 antigen and MPAR of all the three groups were lower than pre-treatment( P <0.01),but there was no significant difference between the three groups( P >0.05). CONCLUSION: Clopidogrel takes effect quickly. Loading dose 300 mg can inhibit platelet activation in 2 hours,and achieve the similar effect gained by 3 successive days' administration of routine dose of clopidogrel or ticlopidine.