Tanshinone ⅡA Sulfonic Acid Sodium Injection To The Effects Of Antiplatelet Effects Of Clopidogrel

Objective:To study the Tanshinone ⅡA sulfonic acid sodium injection to the effects of antiplatelet activity of clopidogrel.Methods:A total of 75 patients with confirmed coronary heart disease who were admitted to the department of cardiology of the first affiliated hospital of Kunming medical university from march to September,2016 were selected.Patients in the control group were assigned to take clopidogrel 75mg and bid regularly for more than 5 days(≥5 days).Patients in the test group were given Tanshinone ⅡA sulfonate sodium 30mg and qd for more than 7 days(≥7 days)on the basis of taking clopidogrel 75mg and bid regularly for more than 5 days(≥5 days).Basic clinical data(name,gender,grade,blood biochemistry and clotting results)were collected.By using gene chip(DNA samples-PCR amplification-chip hybridization-read)detection in patients with CYP2C19 genotype,according to the testing results of CYP2C19 genotype divided into fast metabolism group(CYP2C19*1*1),metabolic group(CYP2C19*1*2,CYP2C19*1*3),the slow metabolism group(CYP2C19*2*2,CYP2C19*2*3,CYP2C19*3*3),according to the above group according to the determination of the control group and experimental group in turn again after MAR value and clopidogrel active metabolites the blood medicine density.To analyze the correlation between genotype and drug group on platelet aggregation rate in vivo and blood drug concentration of clopidogrel active metabolite.Results:1.The blood concentration of clopidogrel active metabolite in the experimental group was 4.05±3.22,while that of the control group was 2.28±2.12.The blood concentration of the active metabolite in the experimental group was higher than that of the control group,and the difference was statistically significant.2.In the experimental group slow metabolism,metabolic type and fast metabolism in clopidogrel active metabolite of blood drug level was 1.19±0.14、2.41±1.51、6.59±3.13,the fast metabolism genome clopidogrel active metabolite blood concentrations of supreme,slow metabolism model genome clopidogrel active metabolite blood concentrations of minimum,clopidogrel active metabolite of three groups of between the blood medicine density difference was statistically significant;3.The Maximum platelet aggregation(MAR)values of slow metabolic type,medium metabolic type and fast metabolic type in the control group were 63.38± 12.67,54.87± 12.74 and 42.65± 12.7,respectively.4.In the CYP2C19 fast metabolite group,the active metabolite value of clopidogrel in the experimental group was 6.59±3.13,and that of the control group was 2.54±2.65.The active metabolite value of clopidogrel in the experimental group was higher than that of the control group,and the difference was statistically significant.5.In the CYP2C19 metabolome,the Maximum platelet aggregation(MAR)value of the experimental group was 33.01 ±12.81,while that of the control group was 54.87±12.74,with statistically significant differences.6.The blood concentration of clopidogrel active metabolite in the CYP2C19 slow metabolite group was 1.22±0.19,the blood concentration of clopidogrel active metabolite in the middle metabolite group was 2.26± 1.58,and the blood concentration of clopidogrel active metabolite in the fast metabolite group was 3.85±3.37,showing statistical differences.Conclusions:In the CYP2C19 fast metabolites group,Tanshinone ⅡA sulfonate sodium combined with Tanshinone significantly increased the blood drug concentration of clopidogrel active metabolites.Tanshinone ⅡA sulfonate combined with Tanshinone in the CYP2C19 slow metabolism and medium metabolism genomes significantly reduced the maximum platelet aggregation(MAR)value.