rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2011-7-6-677-684rpcardio-955Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯANTI-INFLAMMATORY EFFECT OF CLOPIDOGREL IN ATHEROSCLEROSISПРОТИВОВОСПАЛИТЕЛЬНОЕ ДЕЙСТВИЕ КЛОПИДОГРЕЛА ПРИ АТЕРОСКЛЕРОЗЕБурячковскаяЛ. И.BuriachkovskaiaL. I.

д.б.н., ведущий научный сотрудник

livbur@mail.ruСумароковА. Б.SumarokovA. B.

к.м.н., старший научный сотрудник

УчительИ. А.UchitelI. A.

к.б.н., научный сотрудник

ГупалоЕ. М.GupaloE. M.

лаборант-исследователь

Российский кардиологический научно-производственный комплексРоссияRussian Cardiology Research and Production ComplexRussian Federation20112101201676677684Copyright © Buriachkovskaia L.I., Sumarokov A.B., Uchitel I.A., Gupalo E.M., 20162016Бурячковская Л.И., Сумароков А.Б., Учитель И.А., Гупало Е.М.Buriachkovskaia L.I., Sumarokov A.B., Uchitel I.A., Gupalo E.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/955

Aim. To analyze the literary and own data about clopidogrel influence on platelets during inflammation and to reveal particularities of its usage in ischemic heart disease (IHD) patients with active inflammation. Material and methods. The platelet morphology and a number of leukocyte-platelet aggregates (LTA) were investigated with scanning electron microscopy in 110 patients with stable angina pectoris of I-III functional class and 18 healthy volunteers. Spontaneous and ADP-induced platelet aggregation were assessed with laser aggregatometre manufactured by LLC “BIOLA”. Mean platelet volume (MPV) was estimated with the hematological analyzer . All investigations were performed in IHD patients before and after 2 months of clopidogrel treatment 75 mg a day. Results. IHD patients demonstrated appearance of LTA and big reticular platelets in the blood, increase in MPV and spontaneous aggregation. ADP-induced platelet aggregation was rarely increased probably due to acetylsalicylic acid therapy in all IHD patients. These platelet activity changes are connected with increased risk of thrombotic events and correlated with inflammation markers levels. After 2 months of clopidogrel treatment LTA number reduced in 4 times and big reticular platelets number decreased in 2.5 times as well as MPV and spontaneous aggregation achieved the normal ranges. Conclusion. Clopidogrel has not only antithrombotic effect but also can diminish platelets morphological and functional changes connected with inflammation.

Цель. Анализ литературы и собственных данных о влиянии клопидогрела на тромбоциты при воспалении и выявление особенностей его использования у больных ишемической болезнью сердца (ИБС) на фоне воспалительной реакции. Материал и методы. У 110 больных стабильной стенокардией напряжения I-III функционального класса и у 18 здоровых добровольцев изучали форму тромбоцитов и количество циркулирующих в крови лейкоцитарно-тромбоцитарных агрегатов (ЛТА) с помощью сканирующей электронной микроскопии. Спонтанную и АДФ-индуцированную агрегацию тромбоцитов исследовали на лазерном агрегометре ООО «Биола». Средний объем тромбоцитов (СОТ) оценивали с помощью гемоанализатора. Все исследования у больных ИБС проводили до и через 2 мес лечения клопидогрелом в дозу 75 мг в день. Результаты. У больных ИБС характерно появление в крови ЛТА, больших ретикулярных тромбоцитов, увеличение СОТ и спонтанной агрегации. АДФ-индуцированная агрегация повышается редко, что может быть связано с включением в исследование больных, находящихся на терапии аспирином. Такая картина связана с повышенным риском тромботических осложнений и коррелирует с уровнем маркеров воспаления. Через 2 мес терапии клопидогрелом в крови больных почти в 4 раза снижалось количество ЛТА, в 2,5 раза число больших ретикулярных тромбоцитов, уменьшался СОТ , приближались к нормальным значениям показатели спонтанной агрегации.  Заключение. Клопидогрел не только обладает антитромботическим эффектом, но и способен уменьшать характерные для воспаления изменения морфологии и функций тромбоцитов.

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The authors declare that there are no conflicts of interest present.