The Mechanism Of Platelet Activation In Patients With Acute Coronary Syndrme And The Intervention Effect Of Ozagrel On Platelet Activation

Coronary atherosclerosis and its blood vessel complications is still one of the diseases with high incidence and mortality in the western country. The degree of incidence and mortality in our country is lower than that in the west, but in the recent years it has the trend of increase annually. The recent 10-year research showed that the death of artherosclerosis patients have some relations with ACS. ACS is a series of clinical syndrome, because of the coronary artery artherosclerotic plaque rupture and coronary artery spasm, which leads to insufficiency of acute coronary and makes acute myocardial ischemia, injury and necrosis. The clinical manifestations are AMI, UAP and SD, the amount with ACS occupies 30~40 percent in CHD patients. Artherosclerosis plaque break and thrombosis is the foundation of pathophysiology of ACS. Platelet is the main composition of the fresh thrombus. Therefore, under the therapeutic principle of stabilizing facilitates plaque, active antiplatelet treatment is the important contents of medical treatment of the ACS. Ozagrel is a specificity TXS inhibitor which can prevent thrombosis from inhibiting platelet aggregation. Now, there are few reports on using Ozagrel to treat ACS. This article discusses the depressant effect of Ozagrel to the platelet activation and its therapeutic action to the ACS patients. This article chooses, 36 ACS patients as a group, who in the Cardiovascular Division of Medicine, China-Japan Union Hospital of Jilin University from October 2002 to April 2003, and 20 persons whose health examination is normal as the contrast group. Apply the method of prospective and subject contrast fore-and-aft treatment; make use of the flow cytometry determinate the CD62P, CD61 expression level in 36 patients with ACS fore-and-aft the treatment with Nitroglycerin and Ozagrel. And then study that in 20 normal persons by contrast. Setting the angina pectoris attack threshold, angina pectoris attack frequency and ST－T changes on electrocardiogram as evaluation contents of clinical therapeutic efficacy. All measurement data are expressed as mean±s. The difference of two groups and fore-and-aft treatment in the same group is expressed with the t-test. The result suggests: ①before treatment the CD62P expression level(89.6±6.9%) in patients with ACS is obviously higher than that in normal control(40.9±7.6%). There is significance difference between two groups(P<0.05). CD61 expression level(91.4±6.9%) in patients with ACS is as well higher than that in normal control(87.1±5.7%), but there is no significant difference between them(P>0.05). ②CD62P expression level(66.1±8.7%) in patients with ACS after the treatment with Nitroglycerin and Ozagrel is lower than that before treatment(89.6±6.9％). There is significant difference between them (P<0.05). After treatment CD61 expression level(84.4±7.0%) is lower than that before treatment(91.4±6.9％). There is no significant difference between them(P>0.05). ③After the treatment with Nitroglycerin and Ozagrel the angina pectoris attack threshold(2.8±1.9) in 36 patients with ACS is higher than that(1.9±1.8) before treatment; The angina pectoris attack frequency(0.6±1.2) is lower than that(2.3±1.3) before treating; The ST－T change number(2.5±1.3) on electrocardiogram after treatment is lower than that(3.3±1.4) before treatment. Various kinds of changes have significant difference fore-and-aft treatment (P<0.05). Platelet is partitioned by the cytoplasm of the mature megakaryocyte in bone marrow, but borne non-nuclear. It have complicated super microstructure, athletic energy metabolism and the especial physiology function of adhere, aggregate and release. The physiology function of platelet is accommodated by PG,cAMP and Ca2+ mechanism inside it. Platelet plays a key function in the process of physiology hemostasis and pathology thrombosis. The endothelium of complete circulating system is a single lay of endothelial cell that restraint smooth muscle cell proliferation, relax blood vessel, inhibit platelet aggreg...