Author/Editor		Zver, Samo; Žontar, Darja
Title		Določitev števila aktiviranih trombocitov s protitelesi za aktivirani fibrinogen in selektin-P pri bolnikih z esencialno trombocitemijo in vpliv antiagregacijskih zdravil
Translated title		Definition of activated thrombocyte number with antibodies for activated fibrinogen and P-selectin in patients with essential thrombocythemia and antiaggregation drug effect
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. Suppl 1
Publication year		2004
Volume		str. I-127-34
Language		slo
Abstract		Background. Essential thrombocythemia (ET) is a chronic myeloproliferative disease with a platelet count within the range of 400-2000 x 10 9/L. Higher percentage of platelets in the circulation of patients with ET express also activation markers on their membranes. Two of such markers are P-selectin and activated fibrinogen on platelet membranes. Because of frequent thrombembolic and also bleeding related complications, treatment of ET is mandatory. Patients whose platelet count is less than 1000 x 10 9/L and who did not suffer any thrombembolic complication during the course of the disease, are ussually treated with an antiaggregation drug, acetylsalicylic acid 100 mg/daily orally. Clopidogrel is an adenosyn-di-phosphate (ADP) receptor antagonist in platelets. There is no routine clinical data about clopidogrel treatment in the patients with ET and only sporadic case reports can be find in the literature. Patients and methods. In our clinical study we compared antiaggregational effects of acetylsalicylic acid and clopidogrel, by measuring the P-selectin level and activated fibrinogen expression on platelet membranes. There were 35 ET patients included, within the age range between 21 and 78 years and with platelet counts within 451-952 x 10 9/L. None of the patients did suffer any thrombembolic complication during the course of the disease. During the sequential 14 day periods, patients received acetylsalicylic acid 100 mg/daily orally, followed by clopidogrel 75 mg/daily orally and ultimativelly, together acetylsalicylic acid 100 mg/daily orally plus clopidogrel 75 mg/daily orally. After each fourteen days period the level of P-selectin and activated fibrinogen activated platelets were determined with monoclonal antibodies on flow cytometer. Statistical evaluation was calculated on the difference of average values between the two small, independent pair groups with the t-test. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Esencialna trombocitemija (ET) je kronična mieloproliferativna bolezen, za katero je značilno povečano število funkcijsko spremenjenih trombocitov v razponu od 400 do 2000 x 10 9/L. Večji delež trombocitov kot pri zdravi populaciji je pri bolnikih z ET tudi aktiviran. Aktivirane trombocite označujeta selektin-P in aktivirani fibrinogen na njihovih membranah. Ker so za bolezen značilni pogostejši trombembolični zapleti in krvavitve, je ET potrebno zdraviti. Skupino bolnikov z ET, ki imajo število trombocitov nižje od 1000 x 10 9/L in niso utrpeli nobenega trombemboličnega zapleta, zdravimo samo z antiagregacijskim zdravilom, acetilsalicilno kislino 100 mg/dan per os. Redna uporaba clopidogrela pri bolnikih z ET ni poznana in je omejena le na posamezne opise primerov v literaturi. Bolniki in metode. V klinični raziskavi smo primerjali antiagregacijski učinek acetilsalicilne kisline in clopidogrela tako, da smo določali deleže izraženega selektina-P in aktiviranega fibrinogena na membranah trombocitov. V raziskavo smo vključili 35 bolnikov z ET v starosti od 21 do 181et, ki so imeli število trombocitov med 451 in 952 X 10 9/L in ki v poteku bolezni niso utrpeli trombemboličnega zapleta. Bolniki so v štirinajst dnevnih zaporednih obdobjih prejemali acetilsalicilno kislino 100 mg/dan per os, clopidogrel 75 mg/dan per os in nato še obe zdravili hkrati v istem odmerku. Po vsakem končanem obdobju smo delež (odstotek) aktiviranih trombocitov določili s pretočnim citometrom z monoklonskimi protitelesi proti selektinu-P in aktiviranemu fibrinogenu. Za izračun razlike med povprečjema dveh majhnih neodvisnih vzorcev smo uporabili t-porazdelitev, oziroma t-test. (Izvleček skrajšan pri 2000 znakih).
Descriptors		PLATELET ACTIVATION PLATELET COUNT P-SELECTIN FIBRINOGEN THROMBOCYTHEMIA, HEMORRHAGIC ASPIRIN PLATELET AGGREGATION INHIBITORS FLOW CYTOMETRY