摘要
目的花生四烯酸(arachidonicacid,AA)途径血小板抑制率代表阿司匹林服用后的抗血小板聚集疗效,本研究分析阿司匹林服用后急性冠脉综合征患者AA途径血小板抑制率,探讨影响阿司匹林服用后抗血小板聚集疗效的因素。方法选取2018-04-01-2018-11-31北京大学国际医院心内科收治的80例急性冠脉综合征患者为研究对象,均应用阿司匹林后接受血栓弹力图AA抑制率检测。根据结果判定分为反应低下组、低出血风险组和高出血风险组3组。分析阿司匹林服用后的AA途径血小板抑制率是否与年龄、性别、体质量、吸烟情况、糖尿病、高血压和低密度脂蛋白(low density lipoprotein,LDL)水平有相关性。结果反应低下组7例(8.75%),低出血风险组37例(46.25%),高出血风险组36例(45.00%)。服用阿司匹林后AA途径血小板抑制率≥50%的比例高达91.25%。3组患者年龄(t=2.515,P=0.088)、性别(χ~2=1.465,P=0.567)、体质量(t=0.909,P=0.407)、吸烟情况(χ~2=1.58,P=0.600)、糖尿病史(χ~2=1.601,P=0.489)、高血压史(χ~2=0.889,P=0.620)和LDL(t=1.453,P=0.240)差异均无统计学意义。血栓弹力图检测1~20d后22例患者复查,20例复查结果与第1次检测结果基本相同。所有患者随访6个月,均未发生血栓事件,仅有1例结肠癌患者发生消化道出血事件。结论急性冠脉综合征患者服用阿司匹林后抗血小板聚集疗效达标率较高,但可见阿司匹林抵抗,没有发现血小板AA途径抑制率与年龄、性别、体质量、吸烟情况、糖尿病、高血压和LDL水平有关联。
OBJECTIVE The platelet inhibition rate of arachidonic acid(AA)pathway represents the antiplatelet aggregation effect after taking aspirin.This study screened the platelet inhibition rate of AA pathway after taking aspirin and explored the factors influencing the antiplatelet aggregation effect after taking aspirin.METHODS Retrospective analysis of 80 patients with acute coronary syndrome in Department of Cardiology,Peking University International Hospital from April 1,2018 to November 31,2018,all received AA inhibition rate test of thromboelastography after aspirin application.According to the results,the patients were divided into three groups:low reaction group,low bleeding risk group and high bleeding risk group.Whether the platelet inhibition rate of AA pathway after aspirin administration is related to age,gender,body mass,smoking,diabetes,hypertension and low density lipoprotein(LDL)level were analyzed.RESULTS Seven cases(8.75%)in hyporesponsiveness group,37 cases(46.25%)in low bleeding risk group and 36 cases(45.00%)in high bleeding risk group.After taking aspirin,the proportion of platelet inhibition rate of AA pathway≥50%was 91.25%.There was no significant difference in age(t=2.515,P=0.088),gender(χ~2=1.465,P=0.567),body mass(t=0.909,P=0.407),smoking(χ~2=1.58,P=0.600),diabetes history(χ~2=1.601,P=0.489),hypertension history(χ~2=0.889,P=0.620)and LDL(t=1.453,P=0.240).22 patients were reexamined 1-20 days after the thrombus elastogram test.The reexamination results of 20 patients were basically the same as that of the first test.All the patients were followed up for 6 months,but no thrombus occurred.Only one case of colon cancer had gastrointestinal bleeding.CONCLUSIONS The standard rate of antiplatelet aggregation effect is high after taking aspirin,but there is aspirin resistance.No association is found between the inhibition rate of platelet AA pathway and age,gender,body mass,smoking,diabetes,hypertension and LDL level.
作者
王光亮
吴雪梅
WANG Guang-liang;WU Xue-mei(Department of Cardiology,Huanggu District of Northeast International Hospital,Shenyang110000,P.R.China;Department of Cardiology,Peking University International Hospital,Beijing100000,P.R.China;Department of Pediatric Neurology,First Hospital of Jilin University,Changchun130000,P.R.China)
出处
《社区医学杂志》
2020年第4期264-268,共5页
Journal Of Community Medicine
基金
国家自然科学基金(81801284).
