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氯吡格雷对冠心病患者血清血管舒张剂刺激磷蛋白磷酸化水平的影响

马萍1,马巧红2,刘志军1,仇玉民1,徐清斌1   

  1. 1. 宁夏医科大学总医院心内科
    2. 宁夏固原市人民医院心内科
  • 收稿日期:2014-03-14 修回日期:2014-06-05 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 徐清斌

Effects of Clopidogrel on Serum Vasodilator-Stimulated Phosphoprotein Phosphorylation Level in Patients with Coronary Artery Disease

MA Ping 1, MA Qiao hong2,LIU Zhi jun1,QIU Yu min1,XU Qing bin1   

  1. 1. Department of Cardiology,the General Hospital of Ningxia Medical University
    2. Department of Cardiology, the Pepple’ s Hospital of Ningxia Guyuan City
  • Received:2014-03-14 Revised:2014-06-05 Published:2014-11-15 Online:2014-11-15
  • Contact: XU Qing bin

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摘要：

【摘要】  目的   通过检测血管扩张刺激磷蛋白(VASP)磷酸化水平， 评价冠心病患者抗血小板聚集治疗前后血小板活性的变化和对氯吡格雷的反应性。   方法   选取正常对照组 28 例， 不予药物干预； 慢性稳定型心绞痛（CSA）95例， 将其随机分为 A（48 例）、B（47 例）组， 分别给予氯吡格雷 75 mg/d、150 mg/d； 非 ST 段抬高型急性冠脉综合征（NST-ACS）67 例， 首次均给予 300 mg 负荷量氯吡格雷， 此后随机分为 C（33 例）、D（34 例）组， 分别序贯给予氯吡格雷 75 mg/d、150 mg/d。 分别于服用氯吡格雷前、服用负荷剂量氯吡格雷 24 h、服用氯吡格雷第 5 天,取肘静脉血用 ELISA 法测定血清 VASP 磷酸化水平。  结果   服药前， A、B、C、D 组血清 VASP 磷酸化水平均低于正常对照组（P＜0.05）。 服药后 5 d：（1）A、B 组血清 VASP 磷酸化水平较服药前无明显变化（P＞ 0.05）；（2）C、D 组服用负荷量氯吡格雷 24 h 及服用维持量第 5 天血清 VASP 磷酸化水平均较服药前明显升高（均 P＜ 0.05）， C、D 组服药后两组间血清VASP 磷酸化水平变化差异无统计学意义。 结论 冠心病患者血清 VASP 磷酸化水平低于正常对照组， 氯吡格雷可提高非 ST 段抬高型急性冠脉综合征患者血清 VASP 磷酸化水平。

关键词: 冠心病, 氯吡格雷, 血管舒张剂刺激磷蛋白, 血小板活化

Abstract:

[Abstract]   Objective   To evaluate the changes of platelet activity before and after anti-platelet treatment in pa?
tients with coronary heart disease, and their responsiveness to clopidogrel through detecting the phosphorylation levels of vasodilator stimulated phosphoprotein (VASP).   Methods   Twenty-eight cases of healthy people were selected as control group . Patients with chronic stable angina pectoris (CSA, n=95) were randomly divided into A (48 cases) group and B (47 cases) group,and were given clopidogrel 75 mg/d or 150 mg/d respectively; Patients with non ST segment elevation acute coronary syndrome (NST-ACS, n=67) were all given 300 mg loading dose of clopidogrel at the first time, then randomly divided into C (33 cases) group and D (34 cases) group, and given clopidogrel 75 mg/d and 150 mg/d respectively. Blood were taken to examine the phosphorylation levels of serum VASP by ELISA before taking clopidogrel, at time point of loading dose and the fifth day of clopidogrel administration .   Results   Before treatment, phosphorylation levels of serum VASP were lower in A, B, C, D groups than those in the normal control group(P＜ 0.05). After treatment of clopidogrel for 5 days: ① In group A and group B ,phosphorylation levels of serum VASP did not change compared to that before treatment (P＞ 0.05). ② In group C and group D, phosphorylation levels of serum VASP were significantly increased at loading dose and the fifth day of clopidogrel administration than those before treatment (P < 0.05), but there were no significant differences in phosphorylation level of VASP was lower group between group C and group D after serum treatment (P > 0.05).   Conclusion     The
phosphorylation level of serum VASP was lower in patients with coronary heart disease than that in normal control group. Clopidogrel can improve the phosphorylation level of serum VASP in NST-ACS patients .

Key words: Coronary artery Disease, Clopidogrel, Vasodilator-stimulated phosphoprotein, Platelet activation