不同剂量氯吡格雷对冠心病患者血清sCD40L水平的影响  

Effects of different dose of clopidogrel on serum sCD40L level in patients with coronary heart disease

作　　者：马巧红[1] 徐清斌[2] 张波涛[1] 陶明莉 马萍[2] 

机构地区：[1]宁夏医科大学 [2]宁夏医科大学总医院心内科,银川750004

出　　处：《广东医学》2014年第7期1102-1104,共3页Guangdong Medical Journal

基　　金：宁夏回族自治区科技攻关计划项目(编号:宁科计字[2010]168号-66)

摘　　要：目的观察冠心病患者服用不同剂量氯吡格雷后血清sCD40L水平的变化。方法选择冠心病患者162例[稳定型心绞痛(SAP)95例,非ST段抬高型急性冠脉综合征(NST-ACS)67例],正常对照者28例。SAP患者分为A、B组,分别给予氯吡格雷75 mg/d、150 mg/d;NST-ACS患者均给予300 mg负荷量氯吡格雷后分为C、D组,分别序贯维持量氯吡格雷75 mg/d、150 mg/d;正常对照组不予药物干预。分别于服药前、服用负荷剂量氯吡格雷24 h、服用氯吡格雷第5天取静脉血用ELISA法测定血清sCD40L浓度。结果冠心病患者血清sCD40L浓度高于正常对照者(P<0.01)。SAP患者服药前血清sCD40L浓度高于服用氯吡格雷后第5天血清sCD40L浓度(P<0.01),且A、B组间血清sCD40L浓度差异无统计学意义(P>0.05)。NST-ACS患者服药前血清sCD40L浓度高于服用300 mg负荷量氯吡格雷24 h后血清sCD40L浓度(均P<0.05),同时高于序贯常规剂量氯吡格雷第5天血清sCD40L浓度(均P<0.01),但C、D组间第5天sCD40L浓度差异无统计学意义(P>0.05)。结论冠心病患者血清sCD40L浓度高于正常人群,氯吡格雷可降低冠心病患者血清sCD40L浓度。Objective To investigate the effects of different doses of clopidogrel on the serum sCD40L in CHD patients.Methods A total of 162 patients with CHD（ 95 SAP cases,67 NST-ACS cases） and 28 controls were selected for study.SAP patients were randomly divided into Group A and B,in which 75 mg / d and 150 mg / d clopidogrel were given,respectively;while NST-ACS patients were given with 300mg loading dose of clopidogrel,and subsequently randomly divided into Group C and D,in which sequentially clopidogrel of 75 mg / d and 150 mg / d were given,respectively.No intervention was given to Group Control.Serum concentrations of sCD40L were measure before taking clopidogrel,24 h after taking loading dose of clopidoprel and on the 5thday by ELISA.Results The concentration of serum sCD40L in patients with CHD was significantly higher than that of controls（ P〈0.01）.Significant reduction in serum sCD40L on the 5thday was revealed in patients with SAP when comparing with baseline（ P〈0.01）;while no significant difference was observed between Group A and B（ P〈0.05）.Significant reduction in serum sCD40L was also observed in patients with NST-ACS 24 h after taking loading dose of clopidogrel and on the 5thday when comparing with baseline（ P〈0.01）;while no significant difference was observed between Group C and D（ P〈0.05）.Conclusion The level of serum sCD40L in patients with CHD is higher than normal controls,which could be reversed by clopidogrel.

关 键 词：冠心病 不同剂量 氯吡格雷 可溶性CD40配体 血小板活化 

分 类 号：R392[医药卫生—免疫学]