摘要
目的:前列环烷(PG I2)-血栓烷A2(TXA2)平衡对维持机体抗血栓-促血栓作用间平衡有重要意义,本研究旨在探讨选择性环氧化酶-2抑制剂美洛昔康与小剂量阿司匹林联用对心血管病患者PG I2-TXA2平衡的影响。方法:选择20例原发性高血压及冠心病患者为研究对象。入选后均口服阿司匹林肠溶片75 mg/d,7 d。自第8天起随机分为两组,一组继续口服阿司匹林肠溶片75 mg/d(第1组,n=10),另一组口服阿司匹林肠溶片75 mg/d及美洛昔康7.5 mg/d(第2组,n=10),均连服4 d。于服药后第8天晨及第12天晨取静脉血,测定PG I2和TXA2的稳定代谢产物6-酮-PGF1α和TXB2,同时测定血小板聚集性。结果:①两组患者血浆TXB2,血清TXB2,血清6-酮-PGF1α,血小板最大聚集率及血小板聚集速率无显著性差异(P>0.05)。②第2组患者血清PGF1α/TXB2比值用药后有下降趋势(P=0.056),第1组患者血清PGF1α/TXB2比值无明显变化(P=0.799)。③第2组中冠心病患者血清PGF1α/TXB2比值联用药后显著下降(P<0.05),第1组中冠心病患者血清PGF1α/TXB2比值前、后两次比较无显著性差异(P>0.05)。结论:心血管病患者联合使用选择性环氧化酶-2抑制剂美洛昔康(7.5 mg/d)和小剂量阿司匹林(75mg/d)后血清PGF1α/TXB2比值下降,这一影响在冠心病患者中尤为显著,反映其使心血管病患者PG I2-TXA2平衡向促血栓形成方向倾斜。
AIM： The balance between biosynthesis of prostacychn （ PGI2 ） and thromboxane A2 （ TXA2 ） has been proved to be important in the prevention of thrombosis. The present study was to investigate the influence of combined therapy of selective cyclooxygenase-2 inhibitor Meloxicam and low-dose Aspirin on PGI2-TXA2 balance of cardiovascular patients. METHODS ： Twenty hypertensive patients with or without coronary heart disease （CHD） were randomly divided into 2 groups. One was combined-therapy group whose numbers received enteric-coated Aspirin 75 mg/d for 11 days. The other was single-therapy group whose numbers received enteric-coated Aspirin 75 mg/d for 7 days and enteric-coated Aspirin 75 mg/d with Meloxicam 7.5 mg/d for the next 4 days. The metabolic products of PGI2 and TXA2 （ 6-keto-PGF1α and TXB2 respectively ） were determined by radioimmunoassay of patients＇ fast blood on the eighth and the twelfth morning. Platelets aggregation was also measured. RESULTS： ① The two groups had no significant difference in 6-keto-PGF1α ,TXB2 , maximal platelets aggregation rate and aggregation slope on the eighth morning and on the twelfth morning （ P 〉 0.05 ）. ②There was a trend toward lower ratio of serum 6-keto-PGF1α to TXB2 after combined therapy of Aspirin and Meloxicam whereas there was no such trend in the single-therapy group （ P = 0. 056 and 0. 799 respectively ）. ③The ratio of patients with CHD in the combined-therapy group decreased significantly after combined therapy （ P 〈 0.05 ）, while patients with CHD in the single-therapy group had no significant change in the ratio （ P 〉 0.05 ）. CONCLUSION ： Combined therapy of selective cyclooxygenase-2 inhibitor Meloxicam （ 7.5 mg/d ） and Aspirin （ 75 mg/d ） in cardiovascular patients, especially in patients with CHD, lowered the ratio of serum 6-keto-PGF1α to TXB2, indicating that the PGI2-TXA2 balance is shifted toward a more prothrombotic direction.
出处
《心脏杂志》
CAS
2005年第4期376-379,382,共5页
Chinese Heart Journal
