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標題: | 糖尿病合併阿斯匹靈抗藥性之病患與血小板表面標記、單核球表面標記與細胞微粒之關聯性研究 Association Study of Aspirin Resistance with Platelet Surface Markers, Monocyte Surface Markers and Microparticles in Diabetes |
作者: | Wei-Che Huang 黃偉哲 |
指導教授: | 江福田(Fu-Tien Chiang) |
關鍵字: | 糖尿病,阿斯匹靈抗藥性,PAC-1,CD62E, Diabetes,Aspirin resistance,PAC-1,CD62E, |
出版年 : | 2013 |
學位: | 碩士 |
摘要: | 簡介: 阿斯匹靈經常用於預防初發或次發的冠心症,避免心臟血管發生阻塞而產生心肌梗塞的情況,然而阿斯匹靈抑制血小板的功能對於糖尿病患卻不顯著,稱之為阿斯匹靈抗藥性,在此研究中,我們將找出糖尿病患之阿斯匹靈抗藥性是否與其血小板表面標記、單核球表面標記與其釋放出的微粒體有關連。
方法: 總共有70名心血管病患受試者參與這次的研究,糖尿病患有24名,其中有6名具有阿斯匹靈抗藥性,非糖尿病患有46名,其中有8名具有阿斯匹靈抗藥性。 此研究共採集兩次血液,第一次採集尚未服用阿斯匹靈的血液,之後須連續至少服用2週的阿斯匹靈後採集第二次的血液。所有受試者皆服用每天一顆100毫克的阿斯匹靈 Bokey EM /cap 100 mg or Tapal/tab 100 mg )。我們使用血小板功能分析儀PFA-100測定血小板的凝集時間,使用流式細胞儀flow cytometry來檢驗血小板與單核球表面的標記: CD62p (P-selectin), PAC-1, CD31, CD42a, CD14 and CD62E。 結果: 在服用阿斯匹靈至少2週後發現,糖尿病患具有阿斯匹靈抗藥性者其血小板上的PAC-1表現量比起尚未服藥前大幅增加 (0.12±0.05, 0.03±0.04, p<0.05 ),而在糖尿病患中活化的內皮細胞所釋放的微粒體在服藥後大幅的減少(171.30±79.00, 237.73±123.82, p<0.05)。 結論: 糖尿病患具有阿斯匹靈抗藥性與血小板的表面受器PAC-1有關,儘管阿斯匹靈在抑制糖尿病患的血小板效果不佳,但在所有的心血管病患中,包含糖尿病患在內,阿斯匹靈仍具有顯著的保護血管系統的作用。 Introduction: Aspirin is integral in the primary and secondary prevention of coronary artery disease and acute coronary syndrome. However, the effect of aspirin on antiplatelet is not very well in diabetes called aspirin resistance (AR). In this study, we investigate whether AR in diabetes is associated with platelet surface receptors, monocyte surface receptors and microparticle. Materials and methods: A total of 70 patients with cardiovascular disease were enrolled. Twenty-four patients had diabetes and six of them had AR. Forty-six patients were diabetes and eight of them were AR. Blood samples were obtained twice for this study, first at baseline (pre-ASA), and second was after at least two weeks following the post-ASA. All subjects received one 100 mg aspirin. (Bokey EM /cap 100 mg or Tapal/tab 100 mg ). We use the PFA-100 to evaluate platelet aggregation and flow cytometry to evaluate CD62p (P-selectin), PAC-1, CD31, CD42a, CD14 and CD62E. Results: The PAC-1 expression was enhanced in diabetes with AR in post-aspirin than in pre-aspirin (0.12±0.05, 0.03±0.04, p<0.05). The CD62E counts reduced in post-aspirin compared to pre-aspirin (171.30±79.00, 237.73±123.82, p<0.05). Conclusion: AR in diabetes is associated with high PAC-1 expression. Although the effect of aspirin on antiplatelet is not very well in diabetes, it still is a vasoprotective agent for CVD. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/60988 |
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