葛根之活性成分Puerarin併用Clopidogrel對預防缺血性腦梗塞之研究

許準榕
台北醫學大學
抗血小板藥物已被建議使用在預防各類血管的病變，例如心肌梗塞、中風和心血管疾病。臨床上已有數類抗血小板藥物應用在預防繼發性缺血性中風的產生，包含了aspirin、ticlopidine和clopidogrel這兩個ADP antagonist以及glycoprotein IIb/IIIa antagonist。在這幾類藥物中，clopidogrel會經由抑制血小板上ADP受體的結合來抑制血小板凝集進而預防血管病變，由於血小板除了會經由ADP受體的活化而凝集外，其他刺激劑所造成的血小板凝集反應亦會經由釋出ADP，來放大血小板凝集反應，造成血栓的形成，故在臨床應用上，clopidogrel與常用的抗血栓藥物asipirin相較，更能有效的降低一些心血管疾病如心肌梗塞、缺血性中風發生的機率。近來的研究指出葛根的活性成分puerarin (100 mg/kg)在大鼠的缺血性中風動物模式中，能有效的減少缺血性中風所產生的腦損傷區域，並有保護腦細胞的功能，而其藥理機轉可能是經由抑制腦細胞的細胞凋亡來保護腦細胞進而改善缺血性腦梗塞所造成的傷害。
關鍵字：台灣蒲公英、類雌激素、骨質疏鬆症

Study the Effect of Puerarin Combined with Clopidogrel on Ischemic Cerebral Infarction

Joen-Rong Sheu
Taipei Medical University
Antiplatelet drugs were utilized on preventing vascular diseases include myocardial infection (MI), stroke and cardiovascular diseases. Several antiplatelet agents with different mechanisms of action are currently available for secondary prevention of ischemic stroke. They include aspirin, ADP receptor antagonist (ticlopidine and clopidogrel) and glycoprotein IIb/IIIa antagonist. Clopidogrel was a highly potent inhibitor of ADP-induced platelet aggregation. Furthermore, it inhibited collagen or thrombin induced platelet aggregation, because of the involvement of released ADP as an amplifier of the aggregation induced by other agonists. Clopidogrel proved more effective than asipirin in reducing subsequent ischaemic strokes and other vascular events in a large clinical trail with recent ischaemic strokes or other atherosclerosis diseases.
關鍵字：antiplatelet drugs；ischaemic stroke；puerarin；clopidogrel