• 作者： 黃瑞雄; 李悌愷
• 作者服務機構： 國立臺灣大學醫學院內科
• 中文摘要： 天竺鼠的血小板常被用來研究新抗血小板製劑之效果。過去20年來，國外雖有些論文研究有關人類與天竺鼠血小板凝集反應之異同，但其資料仍屬有限。最近，我們發展了一種簡易的模式，可於天竺鼠活體內，產生頸動脈血小板性血栓。因此，我們對於天竺鼠與人類血小板凝集反應之異同甚有興趣。本研究中，我們比較三種臨床上常用的抗血栓藥物，即醋柳酸（aspirin）、dipyridamole及pentoxifylline，對天竺鼠及人類體外血小板凝集反應之抑制情形。體外血小板凝集反應係以下列四種促凝集劑之一來引發：二燐酸腺酸（ADP）、膠原質（collagen）、花生四烯酸（arachidonic acid）及凝血（thrombin）。我們將天竺鼠與人類之結果以雙因子變異數分析法（two－way analysis of variance）來比較分析，結果顯示：（1）膠原質所引發之血小板凝集，受三種藥物抑制之情形，天竺鼠與人類很相似。（2）二燐酸腺酸所引發血小板凝集，受三種藥物抑制的情形，天竺鼠與人類也相似，但有一點不同：在人類，pentoxifylline是最能在血小板凝集反應晚期引起血小板去凝集現象（dis－aggregation）的藥物，而在天竺鼠，最能引起該去凝集現象的藥物卻是dipyridamole。（3）花生四烯酸及凝血所引發之血小板凝集，受三種藥物抑制之情形，則天竺鼠與人類間均有差異。（4）綜合四種促血小板凝集劑之結果來看，天竺鼠與人類之血小板凝集反應，可能有一點重要差異：在血小板凝集反應的晚期，即約加入促凝集劑後5～6分鐘，血小板去凝集現象發生之機轉，天竺鼠與人類可能不一樣。 由以上結果，我們獲致兩項結論：（1）當我們要利用天竺鼠的血小板來測試新抗血小板製劑的效果時，膠原質是最適宜的血小板促凝集劑。（2）當我們以天竺鼠的血小板來研究血小板凝集反應時，不管使用那一種促凝集劑，我們應該避免使用凝集反應晚期之結果當作研究的重點，因為如此得到的結果可能無法適當地運用到人類血小板上。
• 英文摘要： Platelets of guinea pigs are frequently used to evaluate the effect of new antiplatelet agents. Althoughseveral studies have compared the platelet aggregation between humans and guinea pigs, but so far theinformation is still limited. In this study, we compare the inhibitory effect of aspirin, dipyridamole andpentoxifylline on the platelet aggregation induced by adenosine diphosphate (ADP), collagen, arach:donicacid and thrombin between humans and guinea pigs. The results for humans and guinea pigs were compar-ed and analysed by two-way analysis of variance (ANOVA). Our results showed：1. The trends whereinthese three drugs suppressed collagen-induced platelet aggregation was very similar in humans and guineapigs. 2. In ADP-induced aggregation, the trend of inhibition caused by the three drugs was also similar inhumans and guinea pigs except that a difference in platelet disaggregation at the late phase of plateletaggregation was noted. 3. In arachidonic acid- and thrombin-induced aggregations, the trend of inhibitioncaused by the three drugs was somewhat different in humans and guinea pigs. 4. Considering all activatorsas a whole, it was found that the status of platelet disaggregation at the late phase of platelet aggregationwas different in humans and guinea pigs. Therefore, we concluded that：1. Collagen was the most appr-opriate platelet activator when we used platelets of guinea pigs to study the effect of new antiplateletagents. 2. When platelets of guinea pigs were used to study platelet aggregation, no matter which activa-tor was used, we should avoid using the late phase of aggregation as the control index for comparison,because the results thus obtained might not be applicable to human platelets.
• 中文關鍵字： platelet aggregation; antithrombotic drugs
• 英文關鍵字： --