奥扎格雷钠干预治疗原发性血小板增多症合并血栓形成的研究

本研究观察了原发性血小板增多症（primary thrombocytosis，PT）患者临床血栓发生率及其与血小板功能变化的关系，探讨阿患者预防性应用血栓素A2抑制剂对其血小板活性的影响及其对血栓的预防和治疗的临床效果。以流式细胞术测定血小板表面的CD62P、PAC-1水平；ELISA方法测定血浆血栓素A2（TXA2）代谢产物TXB2和前列环素（PGI2）代谢产物6-K—PGF1α水平；观察和比较各组血小板功能的变化及其与血栓形成的关系。结果表明：奥扎格雷钠干预治疗前合并血栓组TXB2、CD62P、TXB2／6-keto—PGF1α比值均比未合并血栓组高，统计学差异具有显著性（P〈0．01）；奥扎格雷钠干预治疗后2组各项血小板功能指标除6-keto—PGF1α外，均较治疗前有明显降低（P〈0．01），且合并血栓组在奥扎格雷钠治疗后除CD62P仍较朱合并血栓组高（p〈0．05）以外，其余指标均与未合并血栓组无显著性差异（P〉0．05）。结论：PT合并血栓者血小板多项功能指标均较未合并血栓者异常升高，血小板功能活化也是PT患者血栓发生的高危因素。奥扎格雷钠均可使2组患者血小板活化指标明显降低，体内TXA2的生成减少和TXA2／PGI2的比值改善.奥扎格雷钠不但具有治疗血栓作用，而且还有较好的预防血栓效果。

Effects of Sodium Ozagrel in Primary Thrombocytosis Combined with Thrombosis

This study was aimed to investigate the incidence of thrombosis in patients with primary thrombocytosis （PT） and its correlation with function changes of platelets, and to explore the effect of thromboxane A2 （TXA2） inhibitor-ozagrel sodium on platelet activity and its efficacy for prevention and treatment of thrombosis. The CD62P and PAC-1 levels on platelet surface were detected by flow cytometry; the levels of TXB2 （metabolic product of TXA2） and 6- keto-PGF1α （metabolic product of prostacyclin ） were detected by FLISA. The function change of platelets and its correlation with thrombosis were observed and compared in PT patients with and without thrombosis. The results indicated that the TXB2, PAC-1 and CD62P level, and TXB2/6-keto-PGF1α ratio in PT patients with thrombosis were higher than those in PT patients without thrombosis before treatment with ozagrel sodium （p 〈 0.01 ）. After treatment with ozagrel sodium, the function indexes of platelets such as CD62P, PAC-1, TXB2 and TXB2/6-keto-PGF1α except 6-keto-PGF1α in PT patients with and without thrombosis decreased obviously （p 〈 0.01 ）, but there was no significant difference in TXB2, 6-keto-PGF1α and TXB2/6-keto-PGF1α levels between PT patients with and without thrombosis except CD62P and PAC-1. It is concluded that the multiindex of platelets in PT patients with thrombosis are higher than that in PT patients without thrombosis, the activation of plalelet function is a high risk factor for thrombosis of PT patients. The ozagrel sodium can obviously reduce the platelet activation, decrease the production of TXA2 and ameliorate the TXB2/6-keto- PGF1 α ratio. The ozagrel sodium not only possesses therapeutic effect, but also preventive efficacy for thrombosis.