三种血小板抑制剂对急性心肌梗死患者血清hs—CRP，血小板CD62p和CD63表达的影响  

Influence of Three Platelet Inhibitors to CD62p,CD63 Expression of Platelet and Serum hs-CRP in Acute Myocardial Infarction Patients

作　　者：郑军[1] 栾红[1] 张青阳[1] 

机构地区：[1]中国医科大学附属一院检验科,沈阳110001

出　　处：《现代检验医学杂志》2012年第6期95-97,99,共4页Journal of Modern Laboratory Medicine

摘　　要：目的检测急性心肌梗死（AMI）患者血清超敏C反应蛋白（hs—CRP）的含量、血小板颗粒膜蛋白（CD62p）和溶酶体膜蛋白（CD63）的表达情况，分析应用阿斯匹林、氯吡格雷和噻氯匹定治疗AMI时，不同治疗时间段对hs—CRP，CD62P和CD63测定的影响。方法2007年7月～2012年2月中国医科大学附属一院急诊科AMI患者108例，年龄介于30～65岁之间。将其分为三组，即阿斯匹林服用组、氯匹格雷服用组及噻氯匹定服用组，所有患者都使用他汀类降脂药物常规治疗，使用流式细胞仪分别检测各组患者的血小板CD62P和CD63的表达情况，西门子BN-tI全自动免疫分析仪测定hs—CRP的浓度。结果治疗后三组的CD62p和CD63表达均降低，与治疗前相比有显著性差异P〈0．01。其中降低程度依次为噻氯匹定最高，其次是氯匹格雷，最低是阿斯匹林。在用药时间相同时氯匹格雷、噻氯匹定与阿斯匹林比较有显著性差异（P〈O．05）。hs—CRP的变化，阿斯匹林组最为显著，其他两种药物的变化较小。结论噻氯匹定、氯吡格雷对血小板CD62P和CD63表达的抑制优于阿斯匹林，而对于hs—CRP测定的影响却明显低于阿斯匹林，说明噻氯匹定、氯吡格雷能更好地抑制血小板活化，而阿斯匹林能更好地缓解慢性炎症改变。Objective To detect the concentration of hs-CRP and the expression of platelet granule membrane protein （CD62p） and lysosomal membrane protein （CD63） in acute myocardial infarction （AMI） patients,and analyse the influence of aspirin,clopidogrel and ticlopidine. Methods Selected one hundred and eight cases of AMI patients in the First Affiliated Hospital of China Medical University, they were divided into three groups, aspirin taking group,clopidogrel taking group and ticlopidine taking group,were treated with statins drugs. The expression of CD62p and CD63 was detected by flow cytometry and concentration of hs-CRP was detected by Hitachi 7600 analyzer. Results After treatment,the expression of CD62p and CD63 were significantly reduced in three taking drugs groups,the highest was ticlopidine,the followed was chloridogel and the lowest was aspirin,there were significant differences （P〈0.01）. At the same time for taking drugs,there were signifi- cant differences（P〈0.05）. For influence of hs-CRP,the highest one was asprin. Conclusion The function of ticlopidine and clopidogrel to inhibit CD62p and CD63 expression is superior to aspirin＇s for the treatment,and prevention of AMI recur- rence,ticlopidine and clopidogrel are more effective.

关 键 词：阿斯匹林 氯吡格雷 噻氯匹定 血小板颗粒膜蛋白(CD62p) 溶酶体膜蛋白(CD63) 急性心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病] R392.11[医药卫生—内科学]