| Coronary atherosclerosis is a kind of disease that is involved with lipid, plaque formation rupture, platelet activation and aggregation, thrombosis, and et al. Platelet adhesion, activation and dysfunction due to endothelial cell injury and plaque ulcer, rupture, cause a series of active acting and result to thrombosis at last. So effective inhibition in platelet aggregation will decrease acute and chronic complications impossibilities of CAD. The following test is designed to compare the clinical effect of the two new anti - platelet drugs ( cilostazol and clopidogrel) with GMP - 140, which is a index characteristic of platelet activation.Methods1. Case selection: All patients are selected in the circulation unit in the first affiliated hospital of CMU from March to December in 2003. They are diagnosed as unstable angina pectoris by two senior doctors according to the CHD diagnosis standards made by WHO in 1979. , all of them with history over one month.Exclusion standards: (1) age less than 13 or older than 80; (2) acute my-ocardial infarction or stroke in a month; (3) severe hypertension, chronic pulmonary disease, chronic renal failure; (4) with a history of bleeding diseases such as gastrointestinal hemorrhage, brain hemorrhage or other organ hemorrhage ; (5) taking drugs with the effect of anti - platelet at the same time such as aspirin, dipyridamole or other drugs; (6) granulocytopenia or thrombocyto-penia.2. Drugs; cilostazol, including 50 mg cilostazol per tablet; clopidogrel, including 25 mg clopidogrel per tablet.3. Group division; All patients were randomized into 2 groups: one group took CS tablets ( 100mg ) twice a day; the other group took CPG tablets (75mg) once a day; and the two group both took aspirin ( 100mg ) once a day at the same time. The observation period is 8 days, and during the period, other drugs used as basic heart and vessel disease therapy were permit, but anti - coagulation drugs were prohibited.4. Index: The plasma level of GMP - 140 was assayed using ELISA.5. General index: including blood routine examination, plasma prothrombin time, liver function, kidney function were examined before treatment and after eight days therapy, blood routine examination and plasma prothrombin time were examined again.6. Clinical observation; Sex, age, basic disease, blood pressure, symptoms of angina pectoris result of coronary arteriography, adverse events.7. Statistical analysis; All statistical analysis was performed with Windows SPSS 10. 0. Continuous date are presented as mean + SD if normally distributed, q and t test were used. Statistical significance was defined as P <0.05.Result1. The conditions of the two groups:According to the result of coronary arteriograpphy myocardial bridge and normal were excluded. 76 cases were selected, including 36 cases in CS group with mean age (63. 6 +9. 5) years and 40 cases in CPG group with mean age (65. 6 +8.5 ) years. The two groups are comparable before the therapy in sex, primary diseases, blood pressure, liver and kidney function, PTT and coronary diseases.2. The change of the plasma level of GMP - 140 before and after treatment;The plasma level of GMP - 140 of the two groups was high obviously, and there was no statistical significance difference. In CS group, on 3rd day and 8thday, the reduction of the plasma level of GMP - 140 was (34. 43 + 11. 48)% and (52. 37 +8. 87)% ; in CPG group, on 3rd day and 8th day, the reduction of the plasma level of GMP - 140 was ( 39. 64 + 10. 74 ) % and ( 52. 83 + 9. 94) %. In either of the two groups, the concentration of GMP -140 had statistical significance before and after treatment, so did it in 3rd day and in 8th day after treatment, which indicated that CS and CPG could decrease the plasma level of GMP -140.The concentration of GMP -140 of GPG group was lower than CS group (p <0. 05) in the 3rd day after treatment, that is significantly different, which indicated that CPG has faster and stronger effect than CS. However, the conc...
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