阿托伐他汀对血小板活性及凝血系统的影响  

Effect of Atovastatin on levels of platelet alpha-granule membrane glycoprotein 140 and fibrinopeptide A

作　　者：黄琪[1] 王士生[1] 谢明斌[1] 骆荣华[1] 姚强[1] 裴德安[1] 徐正明[1] 王敏[1] 隋向前[1] 

机构地区：[1]杭州市红十字会医院心血管内科,310003

出　　处：《中华老年医学杂志》2014年第11期1167-1170,共4页Chinese Journal of Geriatrics

基　　金：杭州市卫生局课题（2009B020）

摘　　要：目的 观察阿托伐他汀合用抗血小板药物及抗凝药物后对血浆血小板膜糖蛋白140（GMP-140）和纤维蛋白肽A（FPA）的影响. 方法 选择需他汀类药物治疗的高胆固醇血症患者（高脂血症组）50例,在他汀类药物（阿托伐他汀20 mg/d,共6周）使用前、后测定GMP-140和FPA水平及血胆固醇、肝功能、血常规、血凝常规等指标;选择低密度脂蛋白胆固醇低于2.1 mmol/L的冠心病患者50例,应用抗血小板药物和抗凝药物作为对照组;另外选择需他汀类药物治疗的冠心病患者（治疗组）50例,合用抗血小板药物和抗凝药物为研究对象,使用阿托伐他汀20 mg/d 6周,在用药前、后测定GMP-140和FPA水平及血胆固醇水平、肝功能、血常规、血凝常规等指标. 结果 高脂血症组患者入院时GMP-140 （61.9±6.3）μg/L、FPA（53.5±6.1） μg/L,阿托伐他汀治疗6周后血GMP 140（51.2±4.1）μg/L、FPA（42.9±4.2） μg/L,差异有统计学意义（均P＜0.01）;对照组患者入院时血GMP-140 （81.5±11.1）μg/L、FPA（100.7±10.6） μg/L,常规抗血小板和抗凝治疗后,血GMP 140（76.3±9.7） μg/L、FPA（96.5±5.8） μg/L（均P＜0.05）;治疗组患者入院时血GMP140（81.2±15.1） μg/L、FPA（99.0±10.9）μg/L,常规抗血小板及抗凝治疗基础上增加阿托伐他汀治疗后,GMP-140、FPA分别为（71.5±12.3）μg/L、（86.4±6.1）μg/L,与治疗前比较差异有统计学意义（均P＜0.01）;入院时,对照组与治疗组患者的血GMP-140和FPA水平比较差异无统计学意义,两组患者在治疗6周后血GMP-140和FPA水平下降,但与对照组相比较,治疗组患者的血GMP 140和FPA水平下降更明显（均P＜0.01）. 结论 阿托伐他汀能降低GMP-140和FPA水平,合用抗血小板药物及抗凝药物后,能进一步降低GMP-140和FPA水平.Objective To investigate the effect of Atovastatin combined with conventional antiplatelet and anticoagulant drugs on the levels of platelet alpha-granule membrane glycoprotein 140 （GMP-140） and fibrinopeptide A （FPA）.Methods 50 patients with hypercholesteremia received atovastatin 20mg/d for 6 weeks （atovastatin group）.100 patients with coronary heart disease were randomly allocated into control group [patients with low density lipoprotein concentration＜2.1mmol/L,receiving conventional antiplatelet and anticoagulant drugs,n=50） and treatment group （receiving atovastatin 20mg/d for 6 weeks combined with conventional antiplatelet and anticoagulant drugs,n=50）.The levels of GMP-140,FPA,and cholesterol,liver function,blood test and hemagglutination in the three groups were detected before and after treatment.Results Compared with pretreatment,GMP-140 and FPA levels were significantly decreased after 6 weeks of treatment in atovastatin,control group and treatment group [GMP-140：（61.9±6.3）g/L vs.（51.2±4.1） g/L,（81.5±11.1） g/L vs.（76.3±9.7） g/L,（81.2±15.1） g/L vs.（71.5±12.3） g/L; FPA：（53.5±6.1） g/L vs.（42.9±4.2） g/L,（100.7±10.6） g/L vs.（96.5±5.8） g/L,（99.0±10.9） g/L vs.（86.4±6.1） g/L,P＜0.01 or P＜0.05].There were no significant differences in the levels of GMP-140 and FPA between the control and treatment groups before treatment,while after 6 weeks of treatment,the changes in the levels of GMP-140 and FPA were much more in treatment group than in control group （both P＜0.01）.Conclusions Atovastatin can significantly decrease the levels of GMP-140 and FPA,especially in combination with conventional antiplatelet and anticoagulant drugs.

关 键 词：西司他汀类 冠心病 血小板 血液凝固因子 

分 类 号：R541.4[医药卫生—心血管疾病]