西洛他唑对冠心病合并2型糖尿病患者血小板活化和超敏C反应蛋白的影响

目的观察西洛他唑对冠心病（CHD）合并2型糖尿病（2-DM）患者血小板聚集率（PAG）、血小板α颗粒膜糖蛋白（CD62p）和超敏C反应蛋白（hs—CRP）的影响，探讨各项指标的相关性及预后的关系。方法80例冠心病合并糖尿病患者随机分为两组，A组：阿司匹林0．1Qd；B组：阿司匹林0．1Qd＋西洛他唑50mg，Bid；并设健康对照组。分别于入院第二天及用药1周后测定二磷酸腺苷（ADP）、花生四烯酸（AA）诱导的PAG变化，以及CD62p和hs—CRP水平。结果用药前A、B两组PAG（ADP、AA诱导）、CD62p及hs—CRP水平均高于对照组，两组之间无统计学差异；治疗1周后B组的PAG、CD62p及hs—CRP水平较A组显著降低，但CD62p及hs—CRP仍高于对照组。B组用药前后hs-CRP与ADP及AA诱导的PAG、CD62p呈正相关；B组6个月临床观察终点事件的发生率显著低于A组。结论西洛他唑可抑制合并2-DM冠心病患者PAG，降低CD62p及hs—CRP水平，改善预后。

Effects of Cilostazol on Platelet Activation and hs-CRP in Patients with Coronary Heart Disease and 2-Diabetes Mellitus

Objective To study the effects of cilostazol on platelet aggregation rate （PAG）, platelet alpha -granular membrane protein （CD62p） and high sensitive C -recative protein （hs-CRP） in patients with coronary heart disease （CHD） and 2 - diabetes melhtus （2 - DM）, and observe the relationship between these indexes and prognosis. Methods 80 patients with CHD and 2 - DM were randomized in to two groups, group A： aspirin, group B： aspirin ＋ cilostazol. Group A received 100 mg of aspirin daily for 6 months without antiplatelet agent. Group B received 50 mg of cilostazol per twelve hours for 6 months besides aspirin. The heathly people were used as control group. The PAG induced by adenosine diphosphate （ADP） or arachidonic acid （AA）, CD62p and hs-CRP in blood samples were determined on second day and a week later. Results The PAG （induced by ADP or AA）, CD62p and hs-CRP in group A and group B were significantly higher than those in control group before therapy, and differences could not been found between groups A and B. After treatment for 1 week, the PAG, CD62p and hs-CRP of group B were significantly lower than those in group A, but CD62p and hs-CRP were higher than those in control group. The hs-CRP and PAG, the hs-CRP and CD62p in group B were positively related before and after therapy. The clinical accident of group B was lower than group A in six months. Conclusion Cilostazol can significantly decrease the PAG, CD62p and hs-CRP in patients with CHD and 2 - DM and improve the prognosis.