Evaluation of inhibitory effects of anti-platelet agents on platelet aggregation -Usefulness of P-selectin as a marker of platelet activation-

首先，我们评估了阿司匹林、西洛他唑和雷马曲班对富血小板血浆（PRP）和全血的抗血小板聚集作用。结果表明，这些药物能抑制ADP、胶原和花生四烯酸诱导的PRP聚集和可溶性P-选择素（sP-selectin，sP）、转化生长因子β 1（transforminggrowthfactor β 1，TGF-β1）和血栓素B2（thromboxane，TX）的释放反应。这些药物的抑制作用依赖于激动剂。此外，这些药物抑制响应ADP的全血聚集。其次，我们评估了阿司匹林与阿托伐他汀联合治疗（联合治疗组）对接受CABG患者血小板聚集的有效性。我们得到的结果如下：1）联合治疗组在术后第14天的总胆固醇水平明显低于单用阿司匹林组（2）联合治疗组在POD-3和POD-7时的炎性标志物显著低于单药治疗组，3）在POD-14，联合治疗组中的分子循环水平显著低于单药治疗组。4）在POD-14，与单药治疗相比，联合治疗中PRP聚集和响应ADP的分子释放被显着抑制。提示sP-选择素是检测血小板活化的一个有用指标，阿托伐他汀可抑制血小板活化，阿司匹林和阿托伐他汀联合治疗对心绞痛合并高胆固醇血症患者有一定的疗效。

Firstly, we evaluated anti-platelet aggregatory effects of aspirin, cilostazol and ramatroban on platelet-rich plasma (PRP) and whole blood. We obtained results that these drugs suppressed PRP aggregation and release reaction of soluble P-selectin (sP-selectin), transforming growth factor (TGF-β1) and thromboxane (TX) B2 in response to ADP, collagen and arachidonic acid. The inhibitory effects of these drugs were dependent on the agonists. In addition, these drugs suppressed whole blood aggregation in response to ADP. Secondary, we estimated the usefulness of the combination of aspirin with atolvastatin (combined therapy group) on human platelet aggregation in patients receiving CABG. We obtained results as follows ; 1)the levels of total cholesterol in combined therapy group on POD-14 significantly decreased when compared with those in aspirin alone (monotherapy) group, 2)inflammatory markers in combined therapy group on POD-3 and -7 were significantly lower than those in monotherapy group, 3)circulating levels of the molecules in combined therapy group on POD-14 were significantly lower than those in monotherapy group, 4)On POD-14, PRP aggregation and the release of the molecules in response to ADP in combined therapy were significantly suppressed when compared with those in momotherapy. These results suggest that sP-selectin is a useful marker in detecting platelet activation, and atolvastatin may suppress the activation of platelet and combined therapy of aspirin and atolvastatin may be useful for the patients with angina pectoris complicated hypercholesterolemia.