摘要
目的探讨血栓弹力图评价服用不同剂量阿司匹林对血小板抑制率的影响。方法将符合人选条件的缺血性脑卒中或短暂性脑缺血发作（TIA）患者180例按就诊顺序随机分为阿司匹林100mg／d组、阿司匹林200mg／d组、阿司匹林300mrdd组，每组60例，在服药前及服药后7d、6个月、1年应用血栓弹力图检测花生四烯酸途径诱导的血小板抑制率并进行比较。结果三组服药后各时间点血小板抑制率与服药前比较差异有统计学意义（P〈0．05）。服药后阿司匹林100mg／d组和阿司匹林200mr,／,a组血小板抑制率呈逐步减低趋势，而阿司匹林300mg／d组呈轻度递增趋势。三组服药前、服药后7d、服药后6个月血小板抑制率比较差异均无统计学意义（P〉0．05），而服药后1年比较差异有统计学意义（P〈0．05），两两比较阿司匹林300mg／d组血小板抑制率[（93．8±18．6）％]显著高于阿司匹林200mg／d组[（83．7±11．2）％]和阿司匹林100mg／d组[（76．6±12．8）％]（P〈0．05）。阿司匹林100mg／d组血小板抑制率低于50％者9例，阿司匹林200mg／d组5例，阿司匹林300mg／d组3例，阿司匹林300mg／d组1年内发生消化道溃疡出血2例。结论适当的阿司匹林剂量（100、200、300m异，d）均能起到很好的抗血小板作用，在100mg／d基础上增加剂量血小板抑制率在短期内（≤6个月）未见明显增加，但长期（1年）存在差异，可能与阿司匹林抵抗发生较少有关，而出血风险却相对增大。
Objective To evaluate the effect of different doses of aspirin on the platelet inhibition rate by thromboelastography. Methods One hundred and eighty patients with ischemic stroke or transient cerebral ischemic attack （TIA） were randomly divided into aspirin 100 mg/d group （60 patients）, aspirin 200 mg/d group （60 patients） and aspirin 300 mg/d group （60 patients） according to the order of treatment. The platelet inhibition rate which arachidonic acid pathway induced was measured by thromboelastography and compared at different time points （before medication; 7 days, 6 months, 1 year after medication）. Results There were significant differences in the platelet inhibition rate after medication at different time points compared with that before medication in three groups （P 〈 0.05）. After medication at different time points,the platelet inhibition rate of aspirin 100 mg/d group and aspirin 200 mg/d group was gradually decreasing. On the contrary,that of the aspirin 300 mg/d group showed gradually increasing. Cross-sectional comparison of the three groups at different time points showed that there was no significant difference in the platelet inhibition rate among three groups before medication, 7 days, 6 months after medication （P〉 0.05）. However, there was significant difference at 1 year after medication （P 〈 0.05）. The platelet inhibition rate in aspirin 300 mg/d group[ （93.8 ＋ 18.6 ）% ] was higher than that in aspirin 200 mg/d group [ （83.7 ± 11.2）% ] and aspirin 100 mg/d group [ （76.6 ± 12.8 ）% ] （P 〈 0.05 ）. During medication there were 9 patients of less than 50% platelet inhibition rate in aspirin 100 mg/d group, 5 patients in aspirin 200 mg/d group, 3 patients in aspirin 300 mg/d group, and 2 patients of peptie ulcer bleeding in aspirin 300 mg/d group. Conclusions The appropriate dose of aspirin （100,200,300 rag/d） can play a very good anti-platelet effect. Increasing the dose on the basis of 100 mg/d, the platelet inhibition rate shows no increase in the short-term （ ±〈6 months）, but in the long-term （1 year） there may be differences. It may be assoeiated with less aspirin resistance and the relative increasing bleeding risk.
出处
《中国医师进修杂志》
2013年第13期35-38,共4页
Chinese Journal of Postgraduates of Medicine
