抗血小板治疗对糖尿病患者冠状动脉支架术后血小板CD62P的影响  

Effect of antiplatelet therapy on platelet CD62P profile in diabetic patients undergoing percutaneous coronary intervention

作　　者：杨帆[1,2] 王红[1,2] 谭保平[1,2] 何柳平[1,2] 

机构地区：[1]广西医科大学第四附属医院 [2]柳州市工人医院心内科,广西壮族自治区545005

出　　处：《中华实用诊断与治疗杂志》2013年第4期330-332,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广西壮族自治区科技厅项目(桂科攻10124001B-17);柳州市科技厅科研项目(2010030726)

摘　　要：目的探讨阿司匹林与氯吡格雷双联抗血小板治疗对经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后糖尿病患者血小板CD62P表达的变化及意义。方法行PCI的冠心病患者133例,其中合并糖尿病38例(糖尿病组),未合并糖尿病95例(对照组),2组患者PCI前均口服300mg氯吡格雷,继予75mg/d及阿司匹林100mg/d治疗,采用流式细胞术检测用药前及PCI术后1个月血小板CD62P表达阳性率。结果治疗前,对照组与糖尿病组血小板CD62P表达阳性率分别为(18.89±14.49)%和(15.74±10.74)%,差异无统计学意义(P>0.05);治疗1个月后,糖尿病组血小板CD62P表达阳性率((8.89±3.43)%)高于对照组((6.30±3.95)%)(P<0.05),下降幅度低于对照组(P<0.05),2组均较治疗前明显降低(P<0.05)。结论糖尿病患者PCI术后阿司匹林与氯吡格雷联合抗血小板治疗的疗效低于非糖尿病PCI患者。Objective To study the effect of antiplatelet therapy by the combination of aspirin and clopidogrel on the changes and significance of platelet CD62P in diabetic patients undergoing percutaneous coronary intervention （PCI）. Methods A total of 133 patients undergoing percutaneous coronary intervention were divided into diabetes group （n=38） and non-diabetes group （n=95）. All patients were given 300 mg clopidogrel, followed by 75 mg/d clopidogrel and 100 mg/d aspirin. The positive expression rate of CD62P was measured by using flow cytometry before and one month after PCI. Results The positive expression rate of platelet CD62P was （18. 89 ±14. 49）%and （15. 74±10. 74）% in non- diabetes group and diabetes group, respectively, with no significant difference between two groups （P〉0.05）. After one month of antiplatelet treatment, the positive expression rate of CD62P was higher in diabetes group （（8.89±3.43）%） than that in non-diabetes group （（6.30±3.95）M） （P〈0.05）, and much less decrease of CD62P was seen in diabetes group that in non-diabetes group （P〈0.05）. CD62P level decreased more obviously in both groups after antiplaletet therapy （P〈0.05）. Conclusion The antiplatelet therapy by the combination of aspirin and elopidogrel is less effective in diabetes patients than in non-diabetes patients.

关 键 词：糖尿病 经皮冠状动脉介入治疗 CD62 流式细胞术 

分 类 号：R541.4[医药卫生—心血管疾病]